Division of Hematology/Oncology, Department of Medicine, Kameda General Hospital, Chiba, Japan.
Eur J Haematol. 2011 Aug;87(2):123-9. doi: 10.1111/j.1600-0609.2011.01645.x.
Natural killer (NK)/T-cell lymphoma cases are rarely discovered using positron emission tomography/computed tomography (PET/CT). We compared the utility of PET/CT and that of conventional methods (CMs; CT with IV contrast, biopsies from primary sites, and bone marrow examinations) in the staging of extranodal NK/T-cell lymphoma. Nineteen untreated patients with extranodal NK/T-cell lymphoma at three institutions were analyzed. PET/CT and CMs were applied for initial workups following diagnosis. PET/CT and CMs were compared and evaluated for their ability to detect tumor lesions and their influence on the staging and treatment strategies. In total, 116 lesions were detected by CM and PET/CT. Using PET/CT, 108 lesions (93%) were discovered. The number of nodal lesions was 28: all were positive by PET/CT and 26 (93%) by CMs. The number of extranodal lesions was 89: 84 (94%) and 54 (61%) lesions were positive by PET/CT and CMs, respectively. PET/CT was superior to CMs in detecting cutaneous lesions [31/31 lesions (100%) vs. 20/31 lesions (65%), respectively; P=0.042]. Bone marrow involvement was confirmed pathologically in only seven patients; four cases (57%) were positive by PET/CT. Using CMs, ten patients (53%) were stages I-II and nine (47%) were stages III-IV. Using PET/CT, eight patients (42%) were in stages I-II and 11 (58%) were in stages III-IV. PET/CT findings altered the stage and treatment strategy in two cases (11%). Our study demonstrated that PET/CT is a useful tool for detecting extranodal lesions in NK/T-cell lymphoma, particularly cutaneous lesions. PET/CT may therefore influence future staging and treatment strategies.
自然杀伤 (NK)/T 细胞淋巴瘤病例很少通过正电子发射断层扫描/计算机断层扫描 (PET/CT) 发现。我们比较了 PET/CT 与传统方法 (CM；CT 加静脉造影、原发部位活检和骨髓检查) 在结外 NK/T 细胞淋巴瘤分期中的作用。在三个机构对 19 例未经治疗的结外 NK/T 细胞淋巴瘤患者进行了分析。在诊断后，采用 PET/CT 和 CMs 进行初始检查。比较了 PET/CT 和 CMs，评估它们检测肿瘤病变的能力及其对分期和治疗策略的影响。共通过 CM 和 PET/CT 检测到 116 个病变。使用 PET/CT 发现了 108 个病变 (93%)。淋巴结病变数量为 28 个：均为 PET/CT 阳性，26 个 (93%)为 CMs 阳性。结外病变数量为 89 个：84 个 (94%)和 54 个 (61%)病变分别为 PET/CT 和 CMs 阳性。PET/CT 在检测皮肤病变方面优于 CMs [31/31 个病变 (100%)比 20/31 个病变 (65%)；P=0.042]。仅在 7 例患者中经病理证实骨髓受累，其中 4 例 (57%)为 PET/CT 阳性。使用 CMs，10 例患者 (53%)为 I-II 期，9 例 (47%)为 III-IV 期。使用 PET/CT，8 例患者 (42%)为 I-II 期，11 例 (58%)为 III-IV 期。PET/CT 结果改变了 2 例患者 (11%)的分期和治疗策略。我们的研究表明，PET/CT 是检测 NK/T 细胞淋巴瘤结外病变的有用工具，尤其是皮肤病变。因此，PET/CT 可能会影响未来的分期和治疗策略。
