Department of Haematology, Singapore General Hospital, Outram Road, Singapore 169608.
Singapore Med J. 2011 Jul;52(7):e156-9.
Lymphomas that manifest initially with haemophagocytic syndrome (HPS) often pose a diagnostic challenge, as the majority of cases have no significant lymphadenopathy for early histological diagnosis. There is paucity of data on specific features of fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography with integrated computed tomography (PET/CT) in patients with lymphoma-associated HPS (LHPS). We describe three cases of LHPS and their characteristic PET imaging features. These three patients had pyrexia and pancytopenia. Their PET/CT images showed extensive and diffuse FDG uptakes in the bone marrow of the axial skeleton, with little involvement in the lymph nodes. They also faced a common initial diagnostic difficulty; the lack of nodal involvement on clinical examination or CT contributed to the delay in the diagnosis of lymphoma. The PET/CT images, however, revealed extensive and distinctive FDG uptakes in the axial skeletal marrow compartment, thus leading to a greater appreciation of the full extent of the disease.
最初表现为噬血细胞综合征（HPS）的淋巴瘤常常带来诊断上的挑战，因为大多数病例在早期组织学诊断时没有明显的淋巴结病。关于淋巴瘤相关噬血细胞综合征（LHPS）患者氟-18-氟代脱氧葡萄糖（FDG）正电子发射断层扫描与计算机断层扫描（PET/CT）的特定特征的数据很少。我们描述了三例 LHPS 及其特征性的 PET 成像特征。这三例患者均有发热和全血细胞减少。他们的 PET/CT 图像显示，轴向骨骼骨髓中存在广泛而弥漫的 FDG 摄取，淋巴结受累较少。他们还面临着共同的初始诊断困难；临床检查或 CT 上缺乏淋巴结受累导致淋巴瘤的诊断延迟。然而，PET/CT 图像显示轴向骨骼骨髓腔中存在广泛而独特的 FDG 摄取，从而更全面地了解了疾病的范围。
