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癌症患者进行PET CT扫描时不可遗忘的一个老对手:结核病。

An old enemy not to be forgotten during PET CT scanning of cancer patients: tuberculosis.

作者信息

Sümbül Ahmet Taner, Sezer Ahmet, Abali Hüseyin, Gültepe Bilge, Koçer Emrah, Reyhan Mehmet, Tonyalı Önder, Özyilkan Özgür

机构信息

Department of Medical Oncology, Medical Faculty, Mustafa Kemal University, Antakya, Turkey.

Department of Medical Oncology, Medical Faculty, Baskent University, Ankara, Turkey.

出版信息

Contemp Oncol (Pozn). 2016;20(2):188-91. doi: 10.5114/wo.2014.43985. Epub 2014 Jul 8.

Abstract

AIM OF THE STUDY

Positron emission tomography-computed tomography (PET CT) scan is commonly used in current medical oncology practice as an imaging method. In this study we present data from cancer patients who were followed at our clinic and suspected of having tuberculosis during PET CT scanning. After the biopsy, they were diagnosed with concomitant tuberculosis.

MATERIAL AND METHODS

In this study, 14 patients who applied to our clinic and followed up due to cancer, and had PET CT scanning for the preliminary staging or further evaluation, were included. The patients were diagnosed with metastatic or recurrent disease, and their biopsy results revealed tuberculosis.

RESULTS

The mean age was 57.8 years with SD (standard deviation) 13.1 years and gender distribution of 78.6% (n = 11) females and 21.4% (n = 3) males. None of the patients had tuberculosis in their personal history (0%). Among the patients, 5 (35.7%) were diagnosed with tuberculosis during the preliminary staging, whereas 9 (64.3%) were diagnosed during the follow-up after the treatment. The median time to tuberculosis diagnosis was 11 months (min-max: 3-24 months) after the treatment. The most commonly involved lymph nodes during PET CT scanning were mediastinal in 8 (64.3%), axillary in 3 (21.4%) and para-aortic in 3 (21.4%) patients. The mean SUVmax (maximum standardised uptake value) of lymph node involved by PET CT scanning was defined as 8.5 (SD 2.6).

CONCLUSIONS

Despite all improvements in modern medicine, tuberculosis is still a serious public health problem. It should always be considered in differential diagnosis while evaluating PET CT scanning results of cancer patients, because it may cause false positive results.

摘要

研究目的

正电子发射断层扫描-计算机断层扫描(PET CT)在当前医学肿瘤学实践中作为一种成像方法被广泛应用。在本研究中,我们展示了在我们诊所接受随访且在PET CT扫描期间疑似患有结核病的癌症患者的数据。活检后,他们被诊断为合并结核病。

材料与方法

本研究纳入了14例因癌症前来我们诊所就诊并接受随访,且为进行初步分期或进一步评估而接受PET CT扫描的患者。这些患者被诊断为转移性或复发性疾病,其活检结果显示患有结核病。

结果

患者的平均年龄为57.8岁,标准差为13.1岁,性别分布为女性78.6%(n = 11),男性21.4%(n = 3)。所有患者个人史中均无结核病(0%)。在患者中,5例(35.7%)在初步分期时被诊断为结核病,而9例(64.3%)在治疗后的随访期间被诊断。结核病诊断的中位时间为治疗后11个月(最小值-最大值:3 - 24个月)。PET CT扫描期间最常累及的淋巴结为纵隔淋巴结,8例(64.3%);腋窝淋巴结,3例(21.4%);腹主动脉旁淋巴结,3例(21.4%)。PET CT扫描累及的淋巴结的平均SUVmax(最大标准化摄取值)定义为8.5(标准差2.6)。

结论

尽管现代医学有了诸多进步,但结核病仍然是一个严重的公共卫生问题。在评估癌症患者的PET CT扫描结果进行鉴别诊断时,应始终考虑到结核病,因为它可能导致假阳性结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/384c/4925724/91e6fb263461/WO-20-23135-g001.jpg

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