Iino Masaki, Iizuka Chifumi
Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Japan.
Rinsho Ketsueki. 2012 May;53(5):540-2.
A 55-year-old man with bilateral cervical lymphadenopathy was diagnosed with diffuse large B-cell lymphoma, stage IIA, and underwent sequential chemoradiotherapy (R-CHOP, 3 courses followed by 30 Gy cervical irradiation). Chemotherapy response was evaluated by 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET). 18F-FDG uptake of the primary lesion was completely diminished; however, a new paratracheal uptake was observed. FDG-PET-guided biopsy revealed sarcoidosis. Sarcoidosis with lymphoma is a rare condition, and it is difficult to distinguish early-stage sarcoidosis from lymphoma without biopsy. Routine FDG-PET significantly increases the detection of unexpected diseases. Physicians should perform biopsies of lesions or follow them carefully in lymphoma patients with unexpected 18F-FDG uptake.
一名55岁双侧颈部淋巴结肿大的男性被诊断为IIA期弥漫性大B细胞淋巴瘤，并接受了序贯放化疗（R-CHOP方案，3个疗程后进行30 Gy颈部照射）。通过18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）评估化疗反应。原发灶的18F-FDG摄取完全消失；然而，观察到气管旁出现新的摄取。FDG-PET引导下的活检显示为结节病。结节病合并淋巴瘤是一种罕见情况，在未进行活检时很难将早期结节病与淋巴瘤区分开来。常规FDG-PET显著提高了意外疾病的检出率。对于18F-FDG摄取异常的淋巴瘤患者，医生应进行病变活检或密切随访。
