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Pulmonary mucosa-associated lymphoid tissue lymphoma: CT and PET/CT imaging findings and follow-up |
LEI Qiang, LI Xin-chun, WAN Qi, ZOU Qiao, YU Yu-dong, BAO Ying-ying, WANG Yu-ze, LIANG Jie-yi |
Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China |
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Abstract Objective: To investigate and improve the CT and PET/CT findings of pulmonary mucosa-associated lymphoid tissue(MALT) lymphoma. Methods: The findings and pathologic data of 27 patients with pathologically confirmed pulmonary MALT lymphoma were retrospectively analyzed on the CT and PET/CT image. Of all cases, 3 cases were with silicosis, Sjogren’s syndrome and tuberculosis, and 4 cases invaded the lung. Twenty four cases had chest CT non enhanced and enhanced scan, 2 cases were of CT scan, 10 cases were underwent PET/CT and CT examination, 1 case was only with PET/CT scan. Results: Twenty four cases with multiple lesions and three cases with solitary lesion were founded in all pulmonary MALT lymphoma cases(twenty seven cases). Twenty seven cases of CT were manifested as pulmonary consolidation, along the subpleural or bronchial vascular bundle and segmental distribution, which crossed the lobes in 16 cases, not in 11 cases, of which 24 cases(24/27, 89%) had expansion of inflamed bronchus, the edge of the lesion with the frosted glass or nodules; while the rest of the lungs associated with multiple ground glass or nodules along bronchial vascular bundles in 18 cases. Lesion density was uniformity, and 4 cases had a little calcification. Mild degree enhancement were in 7 cases, and moderate degree enhancement was in 17 cases, 18 cases were with angiographic signs. Hilar and mediastinal lymphadenopathy was in 4 cases. Pleural effusion was in 7 cases, pleural thickening was in 5 cases. The SUV of 11 cases were 2.5±14.4, with an average of 5.6±2.7. Mediastinal or hilar lymphadenectasis were concentrated was in 7 cases. The SUV ranged from 1.5 to 6.6, among which 3 cases were treated with lacrimal gland, liver or femur radioactivity, SUV ranged from 3.4 to 6.8. Twenty one cases were followed up, stable or complete remission was in 18 cases, progress was in 3 cases. CD20 and CD79a were all positive, CyclinD1 was all negative, Ki-67 positive expression was more than 20%. Conclusion: Pulmonary MALT lymphoma usually appears as multiple nodules and consolidations with air bronchogram and uniform density on CT, and heterogeneous high FDG uptake on PET/CT, and the final diagnosis depends on pathology.
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Received: 12 October 2017
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