眼附属器黏膜相关淋巴组织淋巴瘤MRI和PET/CT表现及临床分析

魏立强; 王景文; 宁丰; 李鑫; 尹秀秀

doi:10.13201/j.issn.1004-2806.2012.04.021

眼附属器黏膜相关淋巴组织淋巴瘤MRI和PET/CT表现及临床分析

- 首都医科大学附属北京同仁医院(北京, 100730)

详细信息

通讯作者: 王景文,E-mail:trwangjw@163.com

中图分类号: R322.9

收稿日期: 2011-10-05

Manifestations and clinical analysis of MRI and 18F-FDG PET/CT in ocular adnexal MALT lymphoma

- Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China

More Information

Corresponding author: WANG Jingwen, E-mail: trwangjw@163.com

Received Date: 05 October 2011

摘要

摘要: 目的:用MRI和¹⁸F-FDG PET/CT准确揭示眼附属器MALT淋巴瘤(OAML)患者的病灶,探讨病灶分布规律及临床病理特点。方法:23例初诊OAML患者确诊前、后行MRI及¹⁸F-FDG PET/CT检查,分析病灶在眼附属器的分布及向全身播散的特点,并总结Ki67阳性率、ALB、LDH、β₂-MG、SUVmax、B症状的特点。结果:每位患者手术前MRI检查至少发现一处病灶,单眼累及者82.6%,双眼累及17.4%;病灶累及眼眶、眼睑、泪腺、结膜的比例分别为60.9%(14/23)、56.5%(13/23)、26.1%(6/23)和13.0%(3/23)。确诊后行全身PET/CT检查,11例(47.8%)患者眼部病灶完全切除且全身无异常代谢活性病灶,12例患者眼部仍有异常代谢活性病灶,SUVmax 5.8±3.0,其中4例患者存在眼部外病灶,主要累及颈部、纵膈、盆腔淋巴结。PET/CT阴性和阳性组患者之间眼部病灶分布无显著性差异,淋巴瘤细胞Ki67阳性率有显著差异。所有患者均无B症状、无贫血、无低白蛋白血症;β₂-MG升高者2例,LDH升高者1例,均为PET/CT发现眼外病灶患者。PET/CT阴性患者均观察随诊,阳性患者选择了联合化疗、局部放疗或观察随诊。结论:大多数OAML患者病灶在局部,MRI和PET/CT能较好地显示眼部及全身病灶,对制定治疗方案有重要价值。有播散病灶者,β₂-MG及LDH有增高趋势。
- 眼 /
- 黏膜相关淋巴组织淋巴瘤 /
- 磁共振成像 /
- 体层摄影术,X线计算机
Abstract: Objective:To accurately detect the lesions using MRI and ¹⁸F-FDG PET/CT in patients with ocular adnexal mucousa-associated lymphoid tissue (MALT) lymphoma and investigate the characteristics of lesion distribution and related clinical pathological parameters. Method:Twenty-three newly diagnosed patients with ocular adnexal MALT lymphoma who received both MRI and ¹⁸F-FDG PET/CT were studied.The characteristics of lesion distribution within ocular adnexa and spreading from primary lesions were also analyzed.Ki67 expression rate,serum albumin,LDH,β₂-MG,SUVmax and B symptoms were summarized. Result:MRI detected lymphoma lesions which were confirmed by followed pathological examination in at least one site in all of the 23 patients.The most frequent site of lymphoma lesions was orbit (60.9%),followed by eyelid (56.5%),lacrimal gland (26.1%) and conjunctiva (13.0%).Bilateral lesions occurred in 17.4% of cases.After lesion excision and biopsy,11 cases had no lymphoma lesions with intensive ¹⁸F-FDG uptake. The other 12 cases still had lymphoma lesions within similar sites founded by previous MRI. Four of the 12 cases also had distant lesions involving the lymphoid nodes in neck,mediastinum or pelvic cavity. There was no significant difference of lesions distribution at ocular adnexa between PET/CT positive and negative groups. Compared to PET/CT negative group,Ki67 expression rate was higher in PET/CT positive group. All of the 23 cases were without anemia,B symptoms and hypoalbuminemia. Elevated LDH and β₂-MG were respectively found in one and two patients who also had spreading lymphoma lesions.All of the 11 cases with PET/CT negative received follow-up and observation.The other cases with PET/CT positive received combined chemotherapy,locoregional radiotherapy or follow-up.Conclusion:MRI and ¹⁸F-FDG PET/CT can accurately detect lymphoma lesions in patients with ocular adnexal MALT lymphoma,which is quite valuable for further management. In most of these patients,the lymphoma lesions are restricted within ocular adnexa. Patients with spreading lesions have a trend of elevating serum LDH and β₂-MG.
- ocular /
- MALT lymphoma /
- magnetic resonance imaging /
- tomography,X-ray

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