异基因造血干细胞移植后发生慢性移植物抗宿主病时急性肿块型多发性硬化症的 FDG PET/CT

FDG PET/CT in Acute Tumefactive Multiple Sclerosis Occurring in a Case of Chronic Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation.

机构信息

From the Departments of *Nuclear Medicine, †Pathology, and ‡Hematology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.

出版信息

Clin Nucl Med. 2016 Sep;41(9):e414-6. doi: 10.1097/RLU.0000000000001193.

DOI:10.1097/RLU.0000000000001193

PMID:26909714

Abstract

Tumefactive multiple sclerosis refers to the presentation of large demyelinating lesions (≥2 cm in diameter) mimicking brain tumors clinically and radiologically. We present the MRI and FDG PET/CT findings in a case with tumefactive multiple sclerosis, who had chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Head MRI showed 7 cerebral lesions with incomplete ring enhancement. All but one lesion had size more than 2 cm. All these demyelinating lesions showed increased uptake at the rims of the lesions with central hypometabolism. Stereotactic brain biopsy of the right frontal lesion revealed extensive macrophage and lymphocyte infiltration.

摘要

肿块样多发性硬化是指大的脱髓鞘病变（直径≥2 厘米）在临床上和放射学上模拟脑瘤。我们介绍一例异基因造血干细胞移植后发生慢性移植物抗宿主病的肿块样多发性硬化患者的 MRI 和 FDG PET/CT 表现。头部 MRI 显示 7 个脑部病变，不完全环形强化。除了一个病变外，所有病变的大小均超过 2 厘米。所有这些脱髓鞘病变在病变边缘摄取增加，中心代谢减低。右侧额部病变的立体定向脑活检显示广泛的巨噬细胞和淋巴细胞浸润。