FDG-PET findings of the brain in lymphomatoid granulomatosis
FDG-PET findings of the brain in lymphomatoid granulomatosis
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DOI：
10.1007/bf02984680
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发表时间：
2006-12-01
影响因子：
2.6
通讯作者：
Nagao, Seigo
中科院分区：
文献类型：
--
作者：
Kawai, Nobuyuki;Miyake, Keisuke;Nagao, Seigo
一位44岁男性，有突发性短期定向障碍的病史，被收住我院。头部T2加权快速自旋回波磁共振成像显示双侧额叶和顶叶白色物质信号增强。钆增强T1加权自旋回波图像显示双侧额顶叶白色质内散在多个点状和线状强化区。尽管F-18-氟脱氧葡萄糖正电子发射断层扫描（[F-18]FDG-PET）未显示双侧额叶和顶叶白色物质中FDG蓄积显著增加，但该扫描的动力学分析显示，与未受影响的枕叶白色物质相比，病变中的己糖激酶活性增加。通过右额叶开放活检进行诊断，病理标本呈淋巴瘤样肉芽肿病（LYG）阳性。患者接受高剂量甲氨蝶呤联合CHOP（环磷酰胺、盐酸多柔比星、硫酸长春新碱和泼尼松龙）化疗，随访MRI显示病变改善。[F-18]FDG-PET检查结合动力学分析可能有助于诊断中枢神经系统LYG。
A 44-year-old man with a history of sudden onset short-term disorientation was admitted to our hospital. T2-weighted fast spin-echo MR images of the head showed increased signal intensity in the bilateral frontal and parietal white matter. Gadolinium-enhanced T1-weighted spin-echo images showed multiple areas with punctate and linear enhancement scattered in the bilateral frontal and parietal white matter. Although F-18-fluorodeoxyglucose positron emission tomography ([F-18]FDG-PET) did not display a significant increase in FDG accumulation in the bilateral frontal and parietal white matter, kinetic analysis of this scan showed increased hexokinase activity in the lesions compared to the unaffected occipital white matter. Diagnosis was made by open biopsy of the right frontal lobe and pathologic specimen was positive for lymphomatoid granulomatosis (LYG). The patient received high-dose methotrexate with CHOP (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisolone) chemotherapy and follow-up MRI showed improvement of the lesions. [F-18]FDG-PET study with kinetic analysis may be useful to diagnose LYG in the central nervous system.