A case of central nervous system lymphomatoid granulomatosis; characteristics of PET imaging and pathological findings
A case of central nervous system lymphomatoid granulomatosis; characteristics of PET imaging and pathological findings
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DOI：
10.1007/s11060-008-9771-6
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发表时间：
2009-06-01
影响因子：
3.9
通讯作者：
Tanaka, Shinya
中科院分区：
文献类型：
--
作者：
Nishihara, Hiroshi;Nakasato, Matsuyoshi;Tanaka, Shinya
中枢神经系统（CNS）的淋巴瘤样肉芽肿病（LYG）是一种罕见的淋巴组织增生性疾病，具有低度恶性潜能。在此报告一例CNS-LYG，特别介绍其放射性同位素影像学特点及病理结果。一名 65 岁男性主诉视力障碍，被指定为同名偏盲。 CT 和 MRI 显示右侧枕叶和顶叶有水肿、增强的不规则结节性病变。尽管 18F-氟脱氧葡萄糖 (FDG)-正电子发射断层扫描 (PET) 扫描显示病灶中的摄取量较低，但蛋氨酸 (MET)-PET 扫描却显示出高摄取量。 3T 质子磁共振波谱 ((1)H-MRS) 显示 N-乙酰天冬氨酸 (NAA) 峰值降低，表明可能存在肿瘤性病变。根据手术切除的材料显示血管周围 CD3 阳性小 T 淋巴细胞浸润并伴有肉芽肿性病变，该患者被诊断为 CNS-LYG。术后类固醇治疗有效，至今放射影像学尚未观察到复发或加重。
Lymphomatoid granulomatosis (LYG) in the central nervous system (CNS) is an uncommon lymphoproliferative disorder with low grade malignant potential. Here we report a case of CNS-LYG, in particular, its characteristics of radioisotope imaging and pathological findings. A 65-year-old man complained of visual disturbance and homonymous hemianopsia was designated. CT and MRI revealed an edematous, enhanced irregular and nodular lesion in the right occipital and parietal lobes. Although 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan showed low uptake in the lesion, Methionine (MET)-PET scan indicated high uptake. Proton magnetic resonance spectroscopy ((1)H-MRS) at 3T revealed a decrease of the peak of the N-acetylaspartate (NAA), suggesting a possible neoplastic lesion. The patient was diagnosed with CNS-LYG based on the surgically removed material showing perivascular infiltration of CD3-positive small T-lymphocytes with granulomatous lesions. The post-operative steroid therapy was effective and the recurrence or exacerbation has not been observed by radiological imaging until now.