Zhang Xuemei, Xu Changyun, Wang Xucai
. Linyi People's Hospital, Linyi, Shandong, China, East Jiangfang Road 27 Linyi, 276000, China.
Hell J Nucl Med. 2016 Jan-Apr;19(1):42-5. doi: 10.1967/s002449910336. Epub 2016 Mar 1.
We present a case of systemic lupus erythematosus (SLE) related autoimmune haemolytic anaemia (AIHA) and lymphadenopathy. AIHA as a serious complication of SLE, requiring urgent appropriate management. The timely differential diagnosis between SLE with lymphadenopathy and lymphoma, primary and SLE-related AIHA often looms as practical challenge under clinical scenario. Fluorine-18 fluorodeoxyglucose position emission tomography/computed tomography ((18)F-FDG PET/CT) performed for fever of a known origin and for possible malignancy, showed increased (18)F-FDG uptake in lymph nodes, as well as increased spleen uptake, which was probably due to lymphoma.
A symmetrically increased (18)F-FDG uptake in small lymph nodes with multiple serous cavity effusion helped the differential diagnosis between SLE related AIHA and lymphoma. In addition, PET/CT can visualize not only the degree of disease activity or the "burden of inflammation" but also the distribution of the disease in the entire body.
我们报告一例系统性红斑狼疮(SLE)相关的自身免疫性溶血性贫血(AIHA)和淋巴结病病例。AIHA是SLE的一种严重并发症,需要紧急进行适当处理。在临床情况下,及时鉴别SLE伴淋巴结病与淋巴瘤、原发性AIHA和SLE相关AIHA往往是一项实际挑战。对已知病因发热及可能存在的恶性肿瘤进行的氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描((18)F-FDG PET/CT)显示,淋巴结及脾脏的(18)F-FDG摄取增加,这可能是淋巴瘤所致。
小淋巴结(18)F-FDG摄取对称增加伴多浆膜腔积液有助于鉴别SLE相关AIHA和淋巴瘤。此外,PET/CT不仅可以显示疾病活动程度或“炎症负荷”,还可以显示疾病在全身的分布情况。