Department of Pediatric Oncology, Cancer Center, Sun Yat-Sen University, Guangzhou, China.
Jpn J Clin Oncol. 2010 Dec;40(12):1128-34. doi: 10.1093/jjco/hyq149. Epub 2010 Aug 7.
Thymic regrowth following chemotherapy has typical clinical and imaging manifestations that can be used to diagnose it prior to pathological diagnosis. We investigated methods for diagnosing thymic regrowth following chemotherapy with non-invasive methods.
Our study included 26 children and adolescents with thymic regrowth following chemotherapy for malignant lymphoma. Computed tomography scans were routinely performed for follow-up observations. After the emergence of new mediastinal masses, patients either underwent Fluorine-18 fluorodeoxyglucose-positron emission tomography scans to identify the characteristics of the mass, or were closely followed up.
Thymic regrowth occurred 1-12 months after the last chemotherapy (mean, 4 months). Computed tomography mostly revealed diffusely enlarged thymic parenchymatous tissues that maintained normal thymic morphology. Computed tomography values were 36.72 ± 9.48 Hu and increased by 5.56 ± 2.62 Hu in contrast enhancement. The mean volume of the mass was 19.2 cm(3). Twenty patients underwent positron emission tomography; among them, five (25%) showed no intake of Fluorine-18 fluorodeoxyglucose in the anterior mediastinal mass, and 15 (75%) showed radioactivity distribution in the mass with a mean standardized uptake value of 2.7; the shape was regular and radioactivity distribution was uniform. The mean follow-up duration was 40 months and all patients achieved disease-free survival.
In the absence of pathological diagnosis, thymic regrowth following chemotherapy can be diagnosed by clinical features combined with characteristic manifestations in computed tomography and positron emission tomography scans.
化疗后胸腺再生具有典型的临床和影像学表现，可在病理诊断前用于诊断。我们研究了使用非侵入性方法诊断化疗后胸腺再生的方法。
我们的研究包括 26 例化疗后恶性淋巴瘤引起的胸腺再生患儿和青少年。常规进行计算机断层扫描（CT）随访观察。在出现新的纵隔肿块后，患者要么进行氟-18 氟代脱氧葡萄糖正电子发射断层扫描（PET）以识别肿块的特征，要么进行密切随访。
化疗结束后 1-12 个月（平均 4 个月）出现胸腺再生。CT 主要显示弥漫性增大的胸腺实质组织，保持正常的胸腺形态。CT 值为 36.72±9.48Hu，增强扫描时增加 5.56±2.62Hu。肿块平均体积为 19.2cm3。20 例患者进行了 PET 检查；其中，5 例（25%）前纵隔肿块无氟-18 氟代脱氧葡萄糖摄取，15 例（75%）肿块内有放射性分布，平均标准摄取值为 2.7；形状规则，放射性分布均匀。平均随访时间为 40 个月，所有患者均无疾病生存。
在没有病理诊断的情况下，结合 CT 和 PET 扫描的特征表现，可以通过临床特征诊断化疗后胸腺再生。
