Xiang Xianhong, Wang Xiaoyan, Yi Qinqin, Lin Lin, Zhang Xiangsong, Liang Hong, Yang Jianyong
Department of Interventional Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.
Department of Nuclear Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.
Mol Clin Oncol. 2014 Nov;2(6):945-948. doi: 10.3892/mco.2014.347. Epub 2014 Jul 11.
Precursor T-cell lymphoblastic lymphoma (T-LBL) is a rare type of malignant lymphoma, with clinical manifestations including diaphragmatic lymph node enlargement, accompanied by local oppression and/or systemic lymphoma symptoms. However, extensive involvement of the mediastinum, pleura and pericardium is rare in T-LBL cases. This is the case report of a T-LBL extensively involving the mediastinum, pleura and pericardium in a 54-year-old woman. The patient complained of anhelation, chest tightness and tiredness for ~3 months. A computed tomography (CT) scan of the chest revealed a diffuse mass of soft tissue density involving the mediastinum, pleura and pericardium. Several thoracocenteses indicated inflammatory changes and cytological examination of the pleural fluid and pleural biopsy under CT guidance identified no heterotypic cells. As F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging revealed a diffused moderate FDG uptake (maximum standard uptake value of 4) by the mediastinum, pleura and cardiac sac, we diagnosed a malignant lymphoma. We subsequently successfully performed needle biopsy under PET/CT guidance according to the PET/CT images and the diagnosis of T-LBL was pathologically confirmed.
前体T细胞淋巴母细胞淋巴瘤（T-LBL）是一种罕见的恶性淋巴瘤，临床表现包括膈淋巴结肿大，伴有局部压迫和/或全身淋巴瘤症状。然而，T-LBL病例中纵隔、胸膜和心包广泛受累的情况罕见。本文报告了一例54岁女性T-LBL广泛累及纵隔、胸膜和心包的病例。患者主诉气喘、胸闷和乏力约3个月。胸部计算机断层扫描（CT）显示纵隔、胸膜和心包有弥漫性软组织密度肿块。多次胸腔穿刺显示有炎症改变，CT引导下胸腔积液的细胞学检查和胸膜活检未发现异型细胞。由于氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/CT成像显示纵隔、胸膜和心包有弥漫性中等程度的FDG摄取（最大标准摄取值为4），我们诊断为恶性淋巴瘤。随后，我们根据PET/CT图像在PET/CT引导下成功进行了穿刺活检，病理证实为T-LBL。
