Sulavik S B, Palestro C J, Spencer R P, Swyer A J, Goldsmith S J, Tierstein A S
University of Connecticut Health Center, Department of Nuclear Medicine, Farmington 06032.
Clin Nucl Med. 1990 Dec;15(12):876-8. doi: 10.1097/00003072-199012000-00005.
In an effort to detect extrapulmonary sites of radiogallium accumulation in cases of sarcoidosis, 145 separate Ga-67 citrate studies of 114 patients with biopsy-proven sarcoidosis were examined. The most characteristic extrapulmonary radiogallium uptake pattern was the "panda sign" in 47 patients (41%). The most common site of prominent extrapulmonary radiogallium uptake was the lacrimal glands in 101 patients (88%). Second most common was activity in one or more superficial lymph node regions such as the cervical, axillary, femoral, or inguinal in 19 patients (17%). Other extrapulmonary sites included breast uptake in 6 out of 80 women (8%), prominent splenic and nasal uptake in 9 (8%) patients, periportal accumulation in 7 (6%), and cutaneous/subcutaneous activity in 4 (4%). Because many of these individuals were receiving corticosteroids, the natural (untreated) prevalence of extrapulmonary findings may be even higher. Although the sensitivity and specificity of extrapulmonary radiogallium accumulation has still to be determined, many of the sites may be accessible to biopsy both for diagnostic purposes and to follow the effects of medications. It is therefore suggested that whole-body imaging be performed when radiogallium is administered to patients with suspected or known sarcoidosis.
为了检测结节病患者肺外放射性镓积聚部位，对114例经活检证实为结节病的患者进行了145次单独的枸橼酸镓-67研究。最具特征性的肺外放射性镓摄取模式是47例患者（41%）出现的“熊猫征”。肺外放射性镓摄取最常见的突出部位是101例患者（88%）的泪腺。第二常见的是19例患者（17%）在一个或多个浅表淋巴结区域出现放射性活性，如颈部、腋窝、股部或腹股沟区。其他肺外部位包括80名女性中有6名（8%）乳房摄取放射性镓，9例（8%）患者脾脏和鼻腔放射性摄取突出，7例（6%）门静脉周围积聚，4例（4%）皮肤/皮下有放射性活性。由于这些患者中有许多正在接受皮质类固醇治疗，肺外表现的自然（未治疗）发生率可能更高。尽管肺外放射性镓积聚的敏感性和特异性仍有待确定，但许多部位可进行活检，用于诊断目的和观察药物疗效。因此，建议对疑似或已知结节病的患者进行放射性镓检查时进行全身成像。
