8例组织细胞坏死性淋巴结炎18F-FDG PET/CT表现及临床分析

目的 分析组织细胞坏死性淋巴结炎（HNL）病人的 ¹⁸F-脱氧葡萄糖（FDG）PET/CT表现及临床资料,提高对该病认识水平。 方法 回顾性分析8例经病理证实的HNL病人的 ¹⁸F-FDG PET/CT资料,其中男4例、女4例,中位年龄26.5岁。分析HNL在 ¹⁸F-FDG PET/CT成像上所示的受累淋巴结分布、形态、密度及摄取,并采用Pearson相关分析来确定淋巴结的 ¹⁸F-FDG最大标准化摄取值（SUV_max）与其长径、短径之间的相关性。 结果 8例HNL病人 ¹⁸F-FDG PET/CT成像均有多部位淋巴结受累,位于颈部8例（6例双侧、2例单侧）,腋窝7例（5例双侧、2例单侧）,肺门及纵隔4例,腹部4例,盆腔3例及腹股沟区2例（均为双侧）。受累淋巴结大都呈椭圆形,无融合,密度较均匀,无钙化及液化坏死。受累淋巴结SUV_max为12.86±5.70,长径为（1.41±0.42） cm,短径为（0.84±0.26） cm,CT值为（44.77±9.59） HU。其中短径<1 cm的淋巴结约占63.4%,SUV_max为11.21±5.80。受累淋巴结SUV_max与长径呈低度正相关（r=0.349,P=0.025）,与短径呈中度正相关（r=0.504,P=0.001）。 结论 ¹⁸F-FDG PET/CT成像在HNL诊断、鉴别诊断及淋巴结活检定位中发挥重要作用。

Clinical and 18F-FDG PET/CT features of histiocytic necrotizing lymphadenitis in 8 cases

Objective By analyzing the clinical and ¹⁸F-fluorodeoxyglucose (FDG) PET/CT features of histiocytic necrotizing lymphadenitis (HNL) to raise awareness of this disease. Methods ¹⁸F-FDG PET/CT data of 8 patients (4 males and 4 females, median age of 26.5 years) with histologically proved HNL were retrospectively analyzed. The distribution, morphology, density and ¹⁸F-FDG uptake of lymph nodes involved in ¹⁸F-FDG PET/CT imaging were analyzed, and the relationships between the maximum standard uptake values (SUV_max) and the long/short diameters were analyzed by Pearson correlation analysis. Results ¹⁸F-FDG PET/CT imaging showed multiple sites lymph node involvement, in neck 8 cases (6 bilateral, 2 unilateral), in axilla 7 cases (5 bilateral, 2 unilateral), in hilum and mediastinum 4 cases, in abdomen 4 cases, in pelvic cavity 3 cases, and in inguinal region 2 cases (both bilateral). The lymph nodes were basically oval without fusion, and the density of them was homogeneous without calcification and liquefaction necrosis. The SUV_max, long diameter, short diameter, and CT value of affected lymph nodes were 12.86±5.70, 1.41±0.42 cm, 0.84±0.26 cm, and 44.77±9.59 HU, respectively. The short diameter of lymph nodes less than 1 cm accounted for 63.4%, and the SUV_max was 11.21±5.80. The SUV_max of lymph nodes showed a mild positive correlation with the long diameter (r=0.349,P=0.025), and a medium positive correlation with the short diameter (r=0.504,P=0.001). Conclusion ¹⁸F-FDG PET/CT imaging plays an important role in the diagnosis and differential diagnosis of HNL and localizing lymph node for biopsy.