ABSTRACT
Objective: To investigate the clinical value of pretreatment 18F-fluorodeoxy glucose positron emission tomography/computed tomography (18F-FDG PET-CT) in extranodal NK/T-cell lymphoma. Methods: Eighty-one patients with pathologically confirmed extranodal NK/T-cell lymphoma and pretreatment with PET-CT scan in Cancer Hospital, Chinese Academy of Medical Sciences from August 2006 to December 2017 were enrolled in the study. The clinical, follow-up and imaging data were analyzed retrospectively. The relationship between maximum standard uptake value (SUVmax) and prognosis were evaluated by Mann-Whitney U test and Spearman rank correlation analysis. Results: Among the 81 patients, 98.8% (80/81) were upper aerodigestive tract (UAT) involved. Lesions at extra-UAT sites were detected in 7 cases, involving parotid gland (n=1), breast (n=1), spleen (n=1), pancreas (n=1), skin and subcutaneous soft tissue (n=1), muscle (n=1), lung (n=2) and bone (n=3). Lymph node involvement were demonstrated in 33 cases. All of the lesions had increased uptake of PET, the median SUVmax was 8.6. PET-CT changed staging in 15 cases, and 12 cases were adjusted treatment methods. 21 cases were changed radiotherapy target because of PET-CT. The 1-, 2-year progression-free survival (PFS) rates were 88.7% and 80.3% while 1-, 2-year overall survival (OS) rates were 97.2% and 94.4% respectively. The median SUVmax of patients with local lymph nodes involvement was significantly higher than those without local lymph nodes involvement (P=0.007). The SUVmax was positively associated with Ann Arbor stage (r=0.366, P=0.001), lactate dehydrogenase (r=0.308, P=0.005) and Ki-67 level (r=0.270, P=0.017). The SUVmax was inversely associated with lymphocyte count (r=-0.324, P=0.003) and hemoglobin content (r=-0.225, P=0.043). Conclusions: Extranodal NK/T-cell lymphoma predominantly occurs in extra-nodal organs, mainly in the upper respiratory and gastrointestinal tracts, with marked FDG-addiction. Compared with conventional imaging, 18F-FDG PET-CT is sensitive and comprehensive in detecting extra-nodal NK/T-cell lymphoma involvement, assisting in accurate clinical staging and treatment planning. Pretreatment SUVmax is potential for prognosis evaluation since it is correlated with prognostic factors.
Subject(s)
Humans , Fluorodeoxyglucose F18 , Lymphoma, Extranodal NK-T-Cell/radiotherapy , Positron Emission Tomography Computed Tomography/methods , Prognosis , Radiopharmaceuticals , Retrospective StudiesABSTRACT
El linfoma extranodal de clulas T/NK tipo nasal es una entidad rara, cuya etiolog¡a est asociada al virus Epstein-Barr, su comportamiento agresivo (20% de sobrevida a 5 a¤os) y es predominante en hombres. Se manifiesta por una lesi¢n tumoral mediofacial destructiva de vasos y necrosis prominente. El diagn¢stico es cl¡nico e inmunohistopatol¢gico y se caracteriza por una marcada agiocentricidad y necrosis tisular, acompa¤ada de infiltrado inflamatorio de linfocitos, histiocitos, clulas plasm ticas y a veces eosfin¢filos. Su inmunofenotipo caracter¡stic es CD2(+), CD56(+), CD3 epsilon (+), CD3 superficie (-), CD7(-), CD16(-), CD30 +/-. A pesar de ser radiosensible, tiene un mal pron¢stico, generalmente, como consecuencia de complicaciones del tratamiento. Se reporta un caso representativo de linfoma extraodal de clulas T/NK tipo nasal de una paciente mujer de 58 anos procedente de Cusco.
Nasal T-cell and natural killer (NK) cell extranodal lymphoma is a rare entity whose etiology is associated with Epstein-Barr, has an aggressive behavior (20% 5-year survival), predominantly in men. Expressed by a midface destructive lesion tumoral of vessels and prominent necrosis. diagnosis is clinical and immunohistochemical is characterized by a marked angiocentricity, and tissular necrosis accompanied by inflamatory infiltrate of lymphocytes, histiocytes, plasma cells and sometimes eosinophils. Its characteristic inmunophenotype is CD2(+), CD56(+), CD3 epsilon (+), CD3 superficie (-), CD7(-), CD16(-), CD30 +/-. Despite being radiosensitive, generally has a poor prognosis due to treatment complications. We report a representative case of nasal T-cell and natural killer cell extranodal lymphoma of a female patient of 58 years from Cusco.