Park Insook, Kang Sungmin
Department of Oral and Maxillofacial Surgery, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-Gu, Daegu, 705-718, Korea.
Department of Nuclear Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-Gu, Daegu, 705-718, Korea.
J Med Case Rep. 2017 Apr 4;11(1):89. doi: 10.1186/s13256-017-1246-y.
We report a case of a patient with appendicular bone involvement of diffuse large B-cell lymphoma visualized by whole-body technetium-99m methylenediphosphonate bone scintigraphy (bone scan) and F-fluorodeoxyglucose positron emission tomography/computed tomography.
A 73-year-old Asian man who had gingival swelling of the labial area of the left maxillary lateral incisor presented to our institution. Positron emission tomography/computed tomography demonstrated hypermetabolic lesions with maximum standardized uptake values of 12.15 in the left testis, 1.92 in the skin of the right chest, and 2.88 in the left ulna and third metatarsal bone. A bone scan showed multiple uptakes in the left ulna, hand, both tibiae, and the left foot. We diagnosed the tumor as diffuse large B-cell lymphoma by excision. Magnetic resonance imaging showed enhanced signaling of lesions with soft tissue edema in the olecranon of the left ulna, the third metacarpal bone of the left hand, and the third metatarsal bone of the left foot. Magnetic resonance imaging findings prompted a diagnosis of lymphoma. Eight cycles of chemotherapy plus external radiotherapy targeted to the involved bone sites were given for 5 months. Follow-up positron emission tomography/computed tomography and bone scanning revealed the disappearance of hypermetabolism and decreased uptake in lesions compared with the previous images. Laboratory data were also all within the normal limits after chemotherapy.
This report highlights that appendicular bone involvement of diffuse large B-cell lymphoma can be detected on whole-body bone scans and by positron emission tomography/computed tomography.
我们报告一例弥漫性大B细胞淋巴瘤累及阑尾骨的病例，该病例通过全身锝-99m亚甲基二膦酸盐骨闪烁显像（骨扫描）和F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描得以可视化。
一名73岁的亚洲男性因左上颌侧切牙唇侧牙龈肿胀前来我院就诊。正电子发射断层扫描/计算机断层扫描显示，左睾丸、右胸皮肤及左尺骨和第三跖骨处存在代谢增高病灶，最大标准化摄取值分别为12.15、1.92和2.88。骨扫描显示左尺骨、手部、双侧胫骨及左脚有多处放射性摄取增高。我们通过切除活检将肿瘤诊断为弥漫性大B细胞淋巴瘤。磁共振成像显示，左尺骨鹰嘴、左手第三掌骨及左脚第三跖骨处病灶信号增强，伴有软组织水肿。磁共振成像结果提示淋巴瘤诊断。给予8个周期的化疗并对受累骨部位进行外照射放疗，持续5个月。随访的正电子发射断层扫描/计算机断层扫描和骨扫描显示，与之前的图像相比，病灶处代谢增高消失，放射性摄取减少。化疗后实验室检查数据也均在正常范围内。
本报告强调，弥漫性大B细胞淋巴瘤累及阑尾骨可通过全身骨扫描及正电子发射断层扫描/计算机断层扫描检测出来。
