Department of Medical Oncology, Dr Lütfi Kırdar Kartal Education and Research Hospital, Selimiye Mah, Şair Nesimi sok, Kardeşler Apt No 1, Daire 4, 34668 Üsküdar, Istanbul, Turkey.
Med Oncol. 2011 Mar;28(1):258-64. doi: 10.1007/s12032-010-9446-y. Epub 2010 Feb 13.
Thymic hyperplasia is a common phenomenon in both children and young adults after chemotherapy and may explain the finding of a mediastinal mass in patients with malignant lymphoma after complete remission. In the present study, we report 5 cases with malignant lymphoma presenting with a mediastinal mass on CT scan after completion of chemotherapy diagnosed as thymic hyperplasia by PET-CT imaging. We retrospectively analyzed 5 patients who presented with anterior mediastinal masses a median of 4 months (range 3-6) after achieving complete remission following successful treatment for malignant lymphoma. Three patients were diagnosed with Hodgkin's lymphoma (HL) and the others with non-Hodgkin's lymphoma (NHL). The median age of the patients was 23 (range of 18-47). PET-CT was performed on these patients to determine the characteristics of a mass which had been detected on CT. PET-CT was performed for all patients, and the thymic masses demonstrated only mild FDG uptake considered to be consistent with thymic hyperplasia. During a median of 24 months of follow-up, all patients were recurrence-free with a median survival of 15 months (range 10-26 months). It is important to be aware of the possibility of thymic hyperplasia after chemotherapy to avoid misdiagnosis or over-staging of disease, as well as unnecessary biopsies, especially when the presenting anterior mediastinal mass was originally located near the thymus on CT scan. Mild FDG PET uptake was sufficient for the diagnosis of benign disease in the cases in this study.
胸腺增生是儿童和青少年在化疗后常见的现象，这可能解释了恶性淋巴瘤患者在完全缓解后出现纵隔肿块的原因。在本研究中，我们报告了 5 例恶性淋巴瘤患者，这些患者在完成化疗后完全缓解后，通过 PET-CT 成像诊断为胸腺增生，表现为 CT 扫描纵隔肿块。我们回顾性分析了 5 例在前纵隔肿块患者，他们在成功治疗恶性淋巴瘤后，完全缓解中位时间为 4 个月（范围 3-6 个月）。其中 3 例为霍奇金淋巴瘤（HL），另外 2 例为非霍奇金淋巴瘤（NHL）。患者的中位年龄为 23 岁（范围 18-47 岁）。对这些患者进行了 PET-CT 检查，以确定 CT 上检测到的肿块的特征。所有患者均进行了 PET-CT 检查，胸腺肿块的 FDG 摄取仅轻度，考虑与胸腺增生一致。在中位 24 个月的随访中，所有患者均无复发，中位生存时间为 15 个月（范围 10-26 个月）。在化疗后要意识到胸腺增生的可能性，以避免误诊或疾病过度分期，以及不必要的活检，特别是当 CT 扫描上的前纵隔肿块最初位于胸腺附近时。在本研究中，轻度 FDG PET 摄取足以诊断为良性疾病。
