Li Wen, Lin Wei, Ma Chao, Zhang Lingyu, Sun Hongjun
Department of Nuclear Medicine, Qianfoshan Hospital Affiliated to Shandong University, Jinan, China.
Hell J Nucl Med. 2016 Jan-Apr;19(1):57-9. doi: 10.1967/s002449910342. Epub 2016 Mar 1.
Intravascular large B-cell lymphoma (IVLBCL) is a rare but fatal malignancy with a rapid onset, and presenting as an aggressive variant of diffuse large B-cell non-Hodgkin's lymphoma. Fluoro-18-fluorine positron emission tomography/computed tomography ((18)F-FDG PET/CT) is reported to be highly sensitive in diagnosing lymphoma. Herein, we present our (18)F-FDG PET/CT findings at an early case of IVLBCL in bilateral adrenals. The patient had no symptoms. Positron emission tomography and CT images showed irregular density on bilateral adrenals indicating malignant tumor and also another tumor on the hepatic flexure of the colon. Both adrenal tumors had a maximum standardized uptake value (SUVmax) of 11.4, whereas the colon tumor had less SUVmax value. Histopathological examination further confirmed that the bilateral adrenal was IVLBCL, whereas the colon mass was a benign tumor.
We describe this case, to highlight the importance of (18)F-FDG-PET/CT in early diagnosis of IVLBCL in bilateral adrenals confirmed by pathology and in differentiating a highly malignant from a benign tumor.
血管内大B细胞淋巴瘤（IVLBCL）是一种罕见但致命的恶性肿瘤，起病迅速，是弥漫性大B细胞非霍奇金淋巴瘤的侵袭性变体。据报道，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）在淋巴瘤诊断中具有高度敏感性。在此，我们展示了一例双侧肾上腺早期IVLBCL患者的（18）F-FDG PET/CT检查结果。该患者无症状。正电子发射断层扫描和CT图像显示双侧肾上腺密度不规则，提示为恶性肿瘤，结肠肝曲处还有另一个肿瘤。双侧肾上腺肿瘤的最大标准化摄取值（SUVmax）为11.4，而结肠肿瘤的SUVmax值较低。组织病理学检查进一步证实双侧肾上腺为IVLBCL，而结肠肿块为良性肿瘤。
我们描述此病例，以强调（18）F-FDG-PET/CT在经病理证实的双侧肾上腺IVLBCL早期诊断以及区分高恶性肿瘤和良性肿瘤方面的重要性。
