白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2014年
5期
281-283,293
,共4页
淋巴瘤,大B细胞,弥漫型%淋巴结%超声检查,多普勒,彩色%正电子发射断层显像术%体层摄影术,计算机
淋巴瘤,大B細胞,瀰漫型%淋巴結%超聲檢查,多普勒,綵色%正電子髮射斷層顯像術%體層攝影術,計算機
림파류,대B세포,미만형%림파결%초성검사,다보륵,채색%정전자발사단층현상술%체층섭영술,계산궤
Lymphoma,large B-cell,diffuse%Lymph nodes%Ultrasonography,Doppler,color%Positron-emission tomography%Tomography,computed
目的 探讨弥漫大B细胞淋巴瘤(DLBCL)化疗后残余淋巴结的血流动力学状态、病理、影像及超声学改变,评价淋巴结性质及其与临床治疗的关系.方法 分析50例经足疗程(R-CHOP方案6～8个疗程)化疗后有残余淋巴结存在的DLBCL患者,对其进行彩色多普勒超声检查,行超声引导下的淋巴结穿刺活组织检查,部分患者残余淋巴结与PET-CT结合,分析残余淋巴结性质.结果 50例DLBCL的患者足疗程化疗后,彩色超声共发现64枚淋巴结.其中42例患者53枚残余淋巴结未见动脉血流,病理活组织检查HE染色符合临床完全缓解标准.另8例患者1 1枚淋巴结超声提示淋巴结周边型血流;同时PET-CT显示这些淋巴结的标准摄取值较高,提示组织处于高代谢状态,与超声动力学状态相符合;选取残余淋巴结再行活组织检查HE染色,可见淋巴结残余病灶组织,未见肿瘤组织.42例治疗有效的患者治疗后残余淋巴结为治疗后炎性反应或是纤维组织增生.结论 经足疗程化疗后的患者淋巴结可持续存在,超声与PET-CT检查对恶性淋巴瘤残余病变的诊断有较好的准确性,化疗后4周复查彩色超声示淋巴结长径＞ 1.5 cm、血流信号呈中心型血流或者周边型,可行PET-CT检查作为评价肿瘤残余性质的参考指标.
目的 探討瀰漫大B細胞淋巴瘤(DLBCL)化療後殘餘淋巴結的血流動力學狀態、病理、影像及超聲學改變,評價淋巴結性質及其與臨床治療的關繫.方法 分析50例經足療程(R-CHOP方案6～8箇療程)化療後有殘餘淋巴結存在的DLBCL患者,對其進行綵色多普勒超聲檢查,行超聲引導下的淋巴結穿刺活組織檢查,部分患者殘餘淋巴結與PET-CT結閤,分析殘餘淋巴結性質.結果 50例DLBCL的患者足療程化療後,綵色超聲共髮現64枚淋巴結.其中42例患者53枚殘餘淋巴結未見動脈血流,病理活組織檢查HE染色符閤臨床完全緩解標準.另8例患者1 1枚淋巴結超聲提示淋巴結週邊型血流;同時PET-CT顯示這些淋巴結的標準攝取值較高,提示組織處于高代謝狀態,與超聲動力學狀態相符閤;選取殘餘淋巴結再行活組織檢查HE染色,可見淋巴結殘餘病竈組織,未見腫瘤組織.42例治療有效的患者治療後殘餘淋巴結為治療後炎性反應或是纖維組織增生.結論 經足療程化療後的患者淋巴結可持續存在,超聲與PET-CT檢查對噁性淋巴瘤殘餘病變的診斷有較好的準確性,化療後4週複查綵色超聲示淋巴結長徑＞ 1.5 cm、血流信號呈中心型血流或者週邊型,可行PET-CT檢查作為評價腫瘤殘餘性質的參攷指標.
목적 탐토미만대B세포림파류(DLBCL)화료후잔여림파결적혈류동역학상태、병리、영상급초성학개변,평개림파결성질급기여림상치료적관계.방법 분석50례경족료정(R-CHOP방안6～8개료정)화료후유잔여림파결존재적DLBCL환자,대기진행채색다보륵초성검사,행초성인도하적림파결천자활조직검사,부분환자잔여림파결여PET-CT결합,분석잔여림파결성질.결과 50례DLBCL적환자족료정화료후,채색초성공발현64매림파결.기중42례환자53매잔여림파결미견동맥혈류,병리활조직검사HE염색부합림상완전완해표준.령8례환자1 1매림파결초성제시림파결주변형혈류;동시PET-CT현시저사림파결적표준섭취치교고,제시조직처우고대사상태,여초성동역학상태상부합;선취잔여림파결재행활조직검사HE염색,가견림파결잔여병조조직,미견종류조직.42례치료유효적환자치료후잔여림파결위치료후염성반응혹시섬유조직증생.결론 경족료정화료후적환자림파결가지속존재,초성여PET-CT검사대악성림파류잔여병변적진단유교호적준학성,화료후4주복사채색초성시림파결장경＞ 1.5 cm、혈류신호정중심형혈류혹자주변형,가행PET-CT검사작위평개종류잔여성질적삼고지표.
Objective To evaluate hemodynamic status,pathological,imaging and ultrasound changes of residual lymph nodes from diffuse large B-cell lymphoma (DLBCL) after chemotherapy and their relationship with clinical treatment after chemotherapy.Methods 50 DLBCL patients undergoing full course of chemotherapy but still bearing residual lymph nodes were examined with ultrasound-guided lymph node biopsy.Some examinations were combined with PET-CT to analyze properties of residual lymph nodes.Results 64 lymph nodes were identified by color Doppler ultrasounda in the 50 DLBCL patients treated with full course of chemotherapy.Among them,53 lymph nodes from 42 patients did not show artery blood flow and HE staining of these lymph node biopsy met the clinical standard for complete remission.For the other 11 lymph nodes from 8 patients,ultrasound examination displayed smrounding blood flow inside.At the same time,PET-CT showed that these lymph nodes had higher SUV values,implying high metabolic state in these tissues,which was in agreement with ultrasonic examination results.However,HE staining of these lymph nodes biopsy demonstrated only residual lesion but no tumor tissue.Conclusions Lymph nodes still exist in DLBCL patients treated with full course of chemotherapy.Ultrasound and PET-CT examination have high accuracy in diagnosing benign and malignant residual lymph nodes in follow-up examination on 4 weeks after chemotherapy showed that lymph nodes are over ＞ 1.5 cm in length and have central or peripheral blood flow.Therefore,PET-CT examination of tumor could be considered as a reference index in characterizing residual tumors after chemotherapy.
