From the Departments of Nuclear Medicine.
Rehabilitation, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, Shanxi, China.
Clin Nucl Med. 2020 May;45(5):405-406. doi: 10.1097/RLU.0000000000002999.
F-FDG PET/CT was performed on a 48-year-old woman with leukocytosis (white blood cell count 57.10 × 10/L, 84.0% neutrophils) and monoclonal gammopathy to investigate the possibility of reactive neutrophilia secondary to plasmacytoma. On the background of skeletal "superscan," the maximum intensity projection image of PET demonstrated the highest metabolic region in the left sacrum, which was confirmed as an osteolytic lesion by CT. Biopsy of the sacral lesion revealed a plasma cell myeloma, indicating the diagnosis of neutrophilic leukemoid reaction associated with multiple myeloma. The white blood cell counts dramatically dropped to the normal level after 1 cycle of chemotherapy for multiple myeloma.
患者为 48 岁女性，白细胞增多（白细胞计数 57.10×10/L，中性粒细胞 84.0%）伴单克隆丙种球蛋白病，进行 F-FDG PET/CT 检查以明确浆细胞瘤继发反应性中性粒细胞增多的可能性。在骨骼“超级扫描”的背景下，PET 的最大强度投影图像显示左骶骨的最高代谢区域，CT 证实为溶骨性病变。骶骨病变活检显示浆细胞瘤，提示与多发性骨髓瘤相关的嗜中性白细胞类白血病反应的诊断。多发性骨髓瘤 1 个化疗周期后，白细胞计数急剧降至正常水平。
