Kohan A A, Paganini L, Biedak P, Arma J I, Dalurzo M C L, Garcia-Monaco R D
Departamento de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
Rev Esp Med Nucl Imagen Mol. 2013 Sep-Oct;32(5):318-20. doi: 10.1016/j.remn.2012.11.002. Epub 2013 Jan 11.
Intravascular lymphoma is a rare subtype of extranodal Non-Hodgkin's lymphoma. Its prognosis is poor in a high percentage of cases due to its insidious appearance and low clinical suspicion. Its diagnosis is usually only reached after an autopsy. It may affect different organs as a whole or only one organ. It is extremely rare that the lung is the only damaged organ. Its diagnosis depends of the clinician's suspicion and proper evaluation with imaging studies as well as correct selection of the organ to be biopsied. When detected on time, the treatment of choice is a combination of a series of chemotherapy associated to a monoclonal antibody (anti-CD20). We present the case of a male patient who underwent a positron emission tomography-computed tomography with 2-[F-18]-fluoro-2 deoxy-D-glucose (FDG) due to symptoms suggestive of a lymphoproliferative disease with no clear structural abnormalities. The images led to a diagnosis of pulmonary intravascular large B cell lymphoma.
血管内淋巴瘤是结外非霍奇金淋巴瘤的一种罕见亚型。由于其隐匿的表现和较低的临床怀疑度，在高比例病例中其预后较差。其诊断通常仅在尸检后才能得出。它可能会整体累及不同器官或仅累及一个器官。肺部是唯一受损器官的情况极为罕见。其诊断取决于临床医生的怀疑、影像学检查的恰当评估以及活检器官的正确选择。如果能及时发现，首选的治疗方法是一系列化疗与单克隆抗体（抗CD20）联合使用。我们报告一例男性患者，该患者因提示存在无明显结构异常的淋巴增殖性疾病的症状，接受了2-[F-18]-氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描检查。图像结果诊断为肺血管内大B细胞淋巴瘤。
