Jiang Maoqing, Zhao Long, Zheng Jianjun, Zhang Jingfeng, Chen Ping, Zhou Wenlan
Ningbo PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
Front Oncol. 2021 Jul 1;11:650822. doi: 10.3389/fonc.2021.650822. eCollection 2021.
Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a fairly rare subtype of primary cutaneous lymphoma. This study aims to investigate the clinicopathologic features, F-FDG PET/CT findings, and outcome of patients with SPTCL.
A retrospective single-center study enrolled 11 patients with SPTCL between August 2010 and March 2020. A total of 26 F-FDG PET/CT scans were performed, and the initial and follow-up PET/CT imaging features, clinicopathologic and immunohistochemical characteristics, and outcome were analyzed.
The male-to-female ratio was 1.2. The mean age at diagnosis was 24.2 years (age range: 13-48 years). Histopathological examinations revealed atypical T-lymphocyte rimming of individual subcutaneous adipocytes, mostly with CD2, CD3, CD4, CD5, CD8, CD56, T-cell intracellular antigen-1, Granzyme B, and high Ki-67 index. Multiple large skin ulcerations with a maximum diameter of 10 cm were observed in one of the 11 patients (9.1%, 1/11), and hemophagocytic syndrome was found in another one. At initial PET/CT scans, the lesions in all 11 patients showed increased uptake of F-FDG with a wide range of maximum standard uptake value (SUVmax) from 2.0 to 14.9. The morphology of the lesions presented as multiple nodules and/or disseminated plaques mainly involving the trunk and/or limbs. Five patients had extracutaneous non-lymph node lesions with SUVmax of 5.6 ± 2.8 on F-FDG PET/CT. No significant correlation between SUVmax and Ki-67 index was observed (r = 0.19, > 0.05). Follow-up F-FDG PET/CT scans in six patients showed complete remission of the disease in two, partial remission in three, and progressive disease in one. During the follow-up period, there was no death except for the patient with multiple ulcerations who died 4 months after diagnosis of SPTCL.
SPTCL may be a group of heterogeneous diseases with varying degrees of F-FDG uptake. F-FDG PET/CT demonstrates its usefulness in detecting disease extent, providing diagnostic work-up, staging, and evaluating treatment response of SPTCL. Multiple large skin ulcerations may be a factor of poor prognosis for patients with SPTCL.
皮下脂膜炎样T细胞淋巴瘤（SPTCL）是原发性皮肤淋巴瘤中一种相当罕见的亚型。本研究旨在探讨SPTCL患者的临床病理特征、F-FDG PET/CT表现及预后。
一项回顾性单中心研究纳入了2010年8月至2020年3月期间的11例SPTCL患者。共进行了26次F-FDG PET/CT扫描，并分析了初始及随访PET/CT影像特征、临床病理及免疫组化特征以及预后情况。
男女比例为1.2。诊断时的平均年龄为24.2岁（年龄范围：13 - 48岁）。组织病理学检查显示单个皮下脂肪细胞周围有非典型T淋巴细胞环绕，多数表达CD2、CD3、CD4、CD5、CD8、CD56、T细胞胞内抗原-1、颗粒酶B且Ki-67指数较高。11例患者中有1例（9.1%，1/11）出现多个最大直径达10 cm的大皮肤溃疡，另1例发现噬血细胞综合征。在初始PET/CT扫描时，所有11例患者的病灶均显示F-FDG摄取增加，最大标准摄取值（SUVmax）范围较广，为2.0至14.9。病灶形态表现为多个结节和/或弥漫性斑块，主要累及躯干和/或四肢。5例患者有皮肤外非淋巴结病灶，F-FDG PET/CT上的SUVmax为5.6±2.8。未观察到SUVmax与Ki-67指数之间存在显著相关性（r = 0.19，P>0.05）。6例患者的随访F-FDG PET/CT扫描显示，2例疾病完全缓解，3例部分缓解，1例疾病进展。在随访期间，除1例诊断为SPTCL后4个月死于多处溃疡的患者外，无其他死亡病例。
SPTCL可能是一组具有不同程度F-FDG摄取的异质性疾病。F-FDG PET/CT在检测SPTCL的疾病范围、提供诊断检查、分期及评估治疗反应方面显示出其有用性。多个大皮肤溃疡可能是SPTCL患者预后不良的一个因素。
