Mouratidis B, Gilday D L, Ash J M
Division of Nuclear Medicine, Hospital for Sick Children, Toronto, Canada.
Nucl Med Commun. 1994 Mar;15(3):144-7. doi: 10.1097/00006231-199403000-00004.
The accurate staging of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) in children has important therapeutic and prognostic implications. The presence of secondary bone involvement or primary malignant lymphoma of bone can be determined by both radiographic and radionuclide methods. We wished to compare the relative efficacy of bone and 67Ga scintigraphy for detecting the presence of bone involvement by malignant lymphoma. We evaluated 83 children (mean age 12 years) with histologically proven HD and NHL utilizing bone and 67Ga scintigraphy which were performed prior to treatment. Three of these patients had biopsy proven primary malignant lymphoma of bone. Bone scintigraphy detected 18 bone lesions in 13 patients and 67Ga scintigraphy detected the same 18 bone lesions and in addition 101 extraosseous lesions. Radiography confirmed the presence of focal bone lesions. Both osteolytic and osteoblastic lesions were identified. We conclude that bone scintigraphy is not necessary in the initial staging of children with malignant lymphoma unless there are specific osseous symptoms. 67Ga scintigraphy is the radionuclide method of choice in the initial staging of children with malignant lymphoma.
儿童霍奇金病（HD）和非霍奇金淋巴瘤（NHL）的准确分期具有重要的治疗和预后意义。继发性骨受累或原发性骨恶性淋巴瘤的存在可通过放射学和放射性核素方法来确定。我们希望比较骨显像和镓-67闪烁显像在检测恶性淋巴瘤骨受累方面的相对效能。我们对83例（平均年龄12岁）经组织学证实为HD和NHL的儿童进行了评估，在治疗前进行了骨显像和镓-67闪烁显像。其中3例患者经活检证实为原发性骨恶性淋巴瘤。骨显像在13例患者中检测到18处骨病变，镓-67闪烁显像检测到了相同的18处骨病变，此外还检测到101处骨外病变。放射学检查证实了局灶性骨病变的存在。溶骨性和成骨性病变均被识别。我们得出结论，除非有特定的骨症状，在儿童恶性淋巴瘤的初始分期中骨显像并非必要。镓-67闪烁显像在儿童恶性淋巴瘤的初始分期中是首选的放射性核素方法。
