Kramer E L, Volm M, Donahue B, Wasserheit C, Chapnick J, Sanger J, Koslow M
Department of Radiology, NYU Medical Center/Bellevue Hospital Center, New York 10016, USA.
Cancer. 1997 Dec 15;80(12 Suppl):2469-77. doi: 10.1002/(sici)1097-0142(19971215)80:12+<2469::aid-cncr18>3.3.co;2-m.
Both systemic and primary central nervous system (CNS) non-Hodgkin's lymphomas (NHL) occur in people with acquired immune deficiency syndrome (AIDS). The radiographic manifestations may be similar to other neoplasms and opportunistic infections that are also found frequently in AIDS. Furthermore, these diseases may coexist with NHL in the AIDS patient.
To evaluate the use of Tc-99m Lymphoscan (the Fab' fragment of the anti-CD-22 antibody LL-2; Immunomedics, Inc., Morris Plains, NJ) in patients with suspected AIDS lymphoma, we studied 7 patients with 35 sites of suspected disease. Six had CNS lesions suspicious for parenchymal brain lymphoma. Each patient underwent planar and single photon emission computed tomography imaging at 3-5 and 18-24 hours after administration of Lymphoscan. Scintigraphic results were compared with results of conventional diagnostic modalities.
Overall, the sensitivity of Lymphoscan was 92% and the specificity was 86%. In brain lesions, there was 100% sensitivity and 100% specificity. Lymphoscan also had 100% sensitivity for sites of lymphomatous lymphadenopathy and for liver involvement. Although less specific in extracranial sites, Lymphoscan was correctly negative in sites of coexisting adenocarcinoma and pneumonia. Two patients had both parenchymal CNS and systemic lymphoma proven by biopsy.
Lymphoscan appears to be a sensitive and specific method for diagnosing CNS lymphoma in AIDS patients. Although slightly less specific in extracranial sites, it may be helpful in differentiating lymphoma from other etiologies in these patients at risk for multiple neoplasms and opportunistic infections.
系统性和原发性中枢神经系统（CNS）非霍奇金淋巴瘤（NHL）均可发生于获得性免疫缺陷综合征（AIDS）患者。其影像学表现可能与AIDS患者中常见的其他肿瘤和机会性感染相似。此外，这些疾病可能与AIDS患者的NHL共存。
为评估锝-99m淋巴细胞闪烁扫描（抗CD-22抗体LL-2的Fab'片段；Immunomedics公司，新泽西州莫里斯平）在疑似AIDS淋巴瘤患者中的应用，我们研究了7例有35处疑似病变部位的患者。其中6例有怀疑为脑实质淋巴瘤的CNS病变。每位患者在注射淋巴细胞闪烁扫描剂后3 - 5小时和18 - 24小时接受平面和单光子发射计算机断层扫描成像。将闪烁扫描结果与传统诊断方法的结果进行比较。
总体而言，淋巴细胞闪烁扫描的敏感性为92%，特异性为86%。在脑部病变中，敏感性和特异性均为100%。淋巴细胞闪烁扫描对淋巴瘤性淋巴结病部位和肝脏受累部位的敏感性也为100%。虽然在颅外部位特异性较低，但淋巴细胞闪烁扫描在并存腺癌和肺炎的部位结果正确为阴性。2例患者经活检证实同时存在脑实质CNS淋巴瘤和系统性淋巴瘤。
淋巴细胞闪烁扫描似乎是诊断AIDS患者CNS淋巴瘤的一种敏感且特异的方法。虽然在颅外部位特异性略低，但它可能有助于在这些有多种肿瘤和机会性感染风险的患者中区分淋巴瘤与其他病因。
