Université Paris-Sud, AP-HP, Hôpitaux Universitaires Paris-Sud, INSERM U1184, Le Kremlin-Bicêtre, France.
Centre Chirurgicale Marie Lannelongue, Le Plessis-Robinson, France.
Arthritis Rheumatol. 2019 Jul;71(7):1147-1157. doi: 10.1002/art.40829. Epub 2019 May 14.
The usefulness of positron emission tomography-computed tomography (PET-CT) with F-labeled fluorodeoxyglucose ( F-FDG) for the diagnosis of lymphoma in patients with primary Sjögren's syndrome (SS) is unclear, since the abnormalities it reveals may be due to systemic manifestations of SS. This study was undertaken to compare F-FDG-PET-CT in patients with primary SS with lymphoma and those without lymphoma in order to identify patterns associated with lymphoma.
A retrospective study was conducted in 2 centers and included patients who met the American College of Rheumatology/European League Against Rheumatism 2016 criteria for primary SS and had undergone PET-CT. Two independent readers who were blinded with regard to lymphoma diagnosis analyzed PET-CT scans. Abnormalities were compared between patients with and those without lymphoma.
Of the 45 patients included, 15 had lymphoma. Compared to patients without lymphoma, the mean size (P = 0.048) and maximum standardized uptake value (SUVmax) (P = 0.001) of the parotid glands were higher in patients with lymphoma. FDG uptake in the lymph nodes was observed in 53.3% of the patients with lymphoma and 43.3% of the patients without lymphoma, with no difference in the number of sites, uptake pattern, or mean SUVmax. Focal pulmonary uptake (nodules or condensations) was observed in 5 of the patients with lymphoma (33.3%) but only 1 patient without lymphoma (3.3%) (P = 0.01). Having an SUVmax in the parotid gland of ≥4.7 and/or the presence of focal pulmonary lesions was highly suggestive of lymphoma (sensitivity 80%, specificity 83.3%).
Some systemic manifestations of primary SS (lymphadenopathy, pulmonary involvement, and salivary gland involvement) can be visualized by PET-CT. Involvement of the lymph nodes and parotid glands is commonly observed with a similar frequency in SS patients with and those without lymphoma. An SUVmax in the parotid glands of ≥4.7 and/or the presence of focal lung lesions are associated with the diagnosis of lymphoma.
正电子发射断层扫描计算机断层扫描（PET-CT）结合 F-标记的氟代脱氧葡萄糖（ F-FDG）对原发性干燥综合征（SS）患者淋巴瘤的诊断价值尚不清楚，因为其显示的异常可能是由于 SS 的全身表现。本研究旨在比较原发性 SS 合并淋巴瘤患者与无淋巴瘤患者的 F-FDG-PET-CT，以确定与淋巴瘤相关的模式。
在 2 个中心进行了回顾性研究，纳入符合美国风湿病学会/欧洲抗风湿病联盟 2016 年原发性 SS 标准且接受 PET-CT 检查的患者。2 位对淋巴瘤诊断不知情的独立读者对 PET-CT 扫描进行分析。比较了有和无淋巴瘤患者的异常情况。
在 45 例患者中，有 15 例患有淋巴瘤。与无淋巴瘤患者相比，有淋巴瘤患者的腮腺平均大小（P = 0.048）和最大标准化摄取值（SUVmax）（P = 0.001）更高。53.3%的淋巴瘤患者和 43.3%的无淋巴瘤患者的淋巴结有 FDG 摄取，但淋巴结受累部位、摄取模式或平均 SUVmax 无差异。5 例（33.3%）淋巴瘤患者有局灶性肺部摄取（结节或实变），而仅有 1 例（3.3%）无淋巴瘤患者有局灶性肺部摄取（P = 0.01）。腮腺 SUVmax≥4.7 和/或存在局灶性肺部病变高度提示淋巴瘤（敏感性 80%，特异性 83.3%）。
原发性 SS 的一些全身表现（淋巴结病、肺部受累和唾液腺受累）可通过 PET-CT 显示。有和无淋巴瘤的 SS 患者中，淋巴结和腮腺受累的情况通常较为常见且频率相似。腮腺 SUVmax≥4.7 和/或存在局灶性肺部病变与淋巴瘤的诊断相关。
