Hamilton Róisín, Andrews Iain, McKay Pamela, Leach Mike
Department of Hematology.
Leuk Lymphoma. 2014 May;55(5):1049-52. doi: 10.3109/10428194.2013.821201. Epub 2013 Aug 5.
Abstract Positron emission tomography-computed tomography (PET-CT) scanning has been shown to be more sensitive than bone marrow biopsy (BMB) in detecting bone marrow involvement (BMI) in classical Hodgkin lymphoma (cHL). In this 5-year retrospective series, 93 (54%) of all new cases of cHL were staged using PET-CT and BMB. PET-CT identified focal bone marrow uptake in 17/93 (18.3%), whilst only five of these (29.4%) were confirmed by BMB. Abnormal pelvic uptake was seen on PET-CT in these five cases. The other 12 cases were missed, giving BMB a sensitivity of 29.4% and a specificity of 100%. PET-CT upstaged 9.7% of patients compared to CT alone. BMB upstaged only one patient; however, this patient was already stage IV on PET-CT. BMB did not alter clinical management in any case. Bone positivity on PET-CT appeared to correlate with anemia, raised lactate dehydrogenase (LDH) and B symptoms. BMB has little or nothing to offer staging cHL in the PET-CT era.
摘要 正电子发射断层扫描-计算机断层扫描（PET-CT）已被证明在检测经典型霍奇金淋巴瘤（cHL）的骨髓受累（BMI）方面比骨髓活检（BMB）更敏感。在这个为期5年的回顾性系列研究中，93例（54%）cHL新发病例采用PET-CT和BMB进行分期。PET-CT在17/93例（18.3%）中发现局灶性骨髓摄取，而其中只有5例（29.4%）经BMB证实。这5例患者的PET-CT显示盆腔摄取异常。另外12例未被BMB检出，BMB的敏感性为29.4%，特异性为100%。与单独使用CT相比，PET-CT使9.7%的患者分期上调。BMB仅使1例患者分期上调；然而，该患者在PET-CT上已为IV期。在任何情况下，BMB均未改变临床管理。PET-CT上的骨髓阳性似乎与贫血、乳酸脱氢酶（LDH）升高和B症状相关。在PET-CT时代，BMB对cHL分期几乎没有帮助。
