骨髓活检在霍奇金淋巴瘤中的应用。65 例患者的 PET-CT 扫描比较。
Bone marrow trephine biopsy in Hodgkin's lymphoma. Comparison with PET-CT scan in 65 patients.
机构信息
Servicio de Hematología y Hemoterapia, Hospital Universitario de Canarias, Tenerife, España.
Servicio de Medicina Nuclear, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, España.
出版信息
Med Clin (Barc). 2018 Feb 9;150(3):104-106. doi: 10.1016/j.medcli.2017.06.060. Epub 2017 Aug 31.
BACKGROUND AND OBJECTIVES
To compare bone marrow biopsy (BMB) and PET/CT in detecting bone marrow involvement in Hodgkin's lymphoma MATERIAL AND METHODS: Retrospective analysis of 65 patients with both tests in the initial staging or in relapse with special attention to the PET/CT uptake pattern.
RESULTS
In 3 patients (4.6%), the BMB showed bone marrow involvement with the PET/CT being positive in them all: 2 with diffuse+multifocal pattern and one diffuse only. In 11 additional patients (total 14/65, 21%), bone marrow involvement was diagnosed by PET/CT because bone marrow uptake was above hepatic one. The pattern was focal only in 2 cases, multifocal in 5, diffuse in 3 and diffuse+multifocal in one. In these last 4 cases the BMB showed an unspecific myelopathy.
CONCLUSIONS
PET/CT detects all cases with BMB affected and many that escape to biopsy, however when the uptake pattern is diffuse it could be by involvement or reactive hyperplasia and in those cases the BMB should be done.
背景与目的
比较骨髓活检（BMB）和 PET/CT 在检测霍奇金淋巴瘤骨髓受累中的作用。
材料与方法
回顾性分析了 65 例在初始分期或复发时同时进行这两项检查的患者，特别关注了 PET/CT 摄取模式。
结果
在 3 例患者（4.6%）中，BMB 显示骨髓受累，而这些患者的 PET/CT 均呈阳性：2 例为弥漫+多灶性模式，1 例为弥漫性模式。在另外 11 例患者（总计 14/65，21%）中，骨髓受累是通过 PET/CT 诊断的，因为骨髓摄取高于肝脏。摄取模式仅在 2 例中为局灶性，在 5 例中为多灶性，在 3 例中为弥漫性，在 1 例中为弥漫+多灶性。在最后 4 例中，BMB 显示为非特异性骨髓病。
结论
PET/CT 可检测到所有 BMB 受累的病例以及许多逃避活检的病例，但当摄取模式为弥漫性时，可能是受累或反应性增生所致，在这些情况下应进行 BMB。
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