18F-FDG-PET/CT引导下确诊原发性骨骼肌外周T细胞淋巴瘤1例

doi:10.16138/j.1673-6087.2024.06.11

内科理论与实践 ›› 2024, Vol. 19 ›› Issue (06): 413-416.doi: 10.16138/j.1673-6087.2024.06.11

¹⁸F-FDG-PET/CT引导下确诊原发性骨骼肌外周T细胞淋巴瘤1例

艾香艳, 刘杨, 程昉, 赵福涛()

上海交通大学医学院附属第九人民医院风湿免疫科，上海 200011

收稿日期:2024-11-05 出版日期:2024-12-26 发布日期:2025-03-11
通讯作者: 赵福涛 E-mail：ftzhao@moisten.org

A case of primary skeletal muscle peripheral T-cell lymphoma diagnosed by ¹⁸F-FDG-PET/CT

AI Xiangyan, LIU Yang, CHENG Fang, ZHAO Futao()

Department Rheumatology and Immunology, Shanghai Ninth People’s Hospital，Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2024-11-05 Online:2024-12-26 Published:2025-03-11

摘要/Abstract

摘要：

原发性骨骼肌淋巴瘤临床罕见，而原发性骨骼肌的非特指型外周T细胞淋巴瘤更为罕见，因临床表现缺乏特异性，易被误诊和漏诊，目前主要依靠¹⁸F-FDG-PET/CT高代谢特征筛查病灶，并通过活组织检查确诊。本文报道1例以口咽部溃疡伴发热为主要临床表现的病例，多次溃疡部位活检未见异性细胞，PET/CT提示双小腿肌肉和咽部等多处代谢不均匀增高，最终经小腿肌肉活检、HE染色结合免疫组化确诊为原发骨骼肌非特指型外周T细胞淋巴瘤。该病例诊断过程曲折，提示临床需提高对此类罕见病的认知，以期实现早期诊断并改善预后。

关键词: 口咽部溃疡, 外周T细胞淋巴瘤, ¹⁸F-FDG-PET/CT

Abstract:

Primary skeletal muscle lymphoma is rare, and primary skeletal muscle non-specified peripheral T-cell lymphoma (PTCL-NOS) is even rarer. It is prone to be misdiagnosed and missed as its lack of specificity of clinical manifestations. At present, its diagnosis primarily relies on ¹⁸F-FDG-PET/CT to screen hypermetabolic lesions and tissue biopsy to confirm it. This article reports a case of oropharyngeal ulcers accompanied by fever as the main clinical manifestations, while there were no atypical cells found in multiple biopsies of the ulcer sites. PET/CT showed heterogeneous hypermetabolism in the calf muscles of two legs and the pharynx. Finally, the patient diagnosis was confirmed as primary skeletal muscle PTCL-NOS through calf muscle biopsy, hematoxylin and eosin staining (HE) staining and immunohistochemistry. The diagnostic process of the case was challenging. It suggests that recognition of primary skeletal muscle PTCL-NOS needs to be improved to achieve early diagnosis and better prognosis.

Key words: Oropharyngeal ulcers, Primary peripheral T-cell lymphoma, ¹⁸F-FDG-PET/CT

中图分类号:

R733.4

艾香艳, 刘杨, 程昉, 赵福涛. ¹⁸F-FDG-PET/CT引导下确诊原发性骨骼肌外周T细胞淋巴瘤1例[J]. 内科理论与实践, 2024, 19(06): 413-416.

AI Xiangyan, LIU Yang, CHENG Fang, ZHAO Futao. A case of primary skeletal muscle peripheral T-cell lymphoma diagnosed by ¹⁸F-FDG-PET/CT[J]. Journal of Internal Medicine Concepts & Practice, 2024, 19(06): 413-416.

图/表 3

参考文献 16

[1]	Iizuka H, Harada S, Iwao N, et al. Primary skeletal muscle peripheral T-cell lymphoma: an autopsy case report and review of the literature[J]. Intern Med, 2021, 60(20):3309-3315.
[2]	Fragou M, Karakitsos D, Kalogeromitros A, et al. Peripheral T-cell lymphoma presenting as an ischemic stroke in a 23-year-old woman: a case report and review of the literature[J]. J Med Case Rep, 2009, 3:83.
[3]	Alekshun TJ, Rezania D, Ayala E, et al. Skeletal muscle peripheral T-cell lymphoma[J]. J Clin Oncol, 2008, 26(3):501-503. doi: 10.1200/JCO.2007.14.2794 pmid: 18202425
[4]	Chim CS, Loong F, Ooi GC, et al. Primary skeletal muscle lymphoma[J]. Am J Med, 2002, 112(1):79-80. pmid: 11812416
[5]	Liu Z, Medeiros LJ, Young KH. Peripheral T-cell lymphoma with unusual clinical presentation of rhabdomyolysis[J]. Hematol Oncol, 2017, 35(1):125-129. doi: 10.1002/hon.2203 pmid: 25921311
[6]	Tanaka Y, Hayashi Y, Kato J, et al. Diffuse skeletal muscles uptake of [¹⁸F] fluorodeoxyglucose on positron emission tomography in primary muscle peripheral T-cell lymphoma[J]. Intern Med, 2011, 50(18):2021-2024.
[7]	Sasaki K, Yamato M, Yasuda K, et al. Rhabdomyolysis caused by peripheral T-cell lymphoma in skeletal muscle[J]. Am J Emerg Med, 2013, 31(10):1537.
[8]	Yamaguchi H, Hashimoto M, Mizuki T, et al. Skeletal muscle T-cell lymphoma following hemophagocytic syndrome[J]. Rinsho Ketsueki, 2000, 41(9):712-717. pmid: 11070931
[9]	Yang J, Zhang F, Fang H, et al. Clinicopathologic features of primary lymphoma in soft tissue[J]. Leuk Lymphoma, 2010, 51(11):2039-2046.
[10]	李小秋, 李甘地, 高子芬, 等. 中国淋巴瘤亚型分布:国内多中心性病例10 002例分析[J]. 诊断学理论与实践, 2012, 11(2):111-115.
[11]	Gallamini A, Stelitano C, Calvi R, et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study[J]. Blood, 2004, 103(7):2474-2479. doi: 10.1182/blood-2003-09-3080 pmid: 14645001
[12]	Feeney J, Horwitz S, Gönen M, et al. Characterization of T-cell lymphomas by FDG PET/CT[J]. AJR Am J Roentgenol, 2010, 195(2):333-340.
[13]	Savage KJ, Ferreri AJ, Zinzani PL, et al. Peripheral T-cell lymphoma—not otherwise specified[J]. Crit Rev Oncol Hematol, 2011, 79(3):321-329. doi: 10.1016/j.critrevonc.2010.07.007 pmid: 20702104
[14]	Huang HS, Liao CK, Liu TT, et al. TP53 mutations in peripheral mature T and NK cell lymphomas: a whole-exome sequencing study with correlation to p53 expression[J]. Hum Pathol, 2018, 80:145-151.
[15]	Abouyabis AN, Shenoy PJ, Sinha R, et al. A Systematic review and meta-analysis of front-line anthracycline-based chemotherapy regimens for peripheral T-cell lymphoma[J]. ISRN Hematol, 2011, 2011:623924.
[16]	Derenzini E, Casadei B, Pellegrini C, et al. Non-hodgkin lymphomas presenting as soft tissue masses: a single center experience and meta-analysis of the published series[J]. Clin Lymphoma Myeloma Leuk, 2013, 13(3):258-265. doi: 10.1016/j.clml.2012.10.003 pmid: 23246162

¹⁸F-FDG-PET/CT引导下确诊原发性骨骼肌外周T细胞淋巴瘤1例

A case of primary skeletal muscle peripheral T-cell lymphoma diagnosed by ¹⁸F-FDG-PET/CT

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 3

参考文献 16

相关文章 3

编辑推荐

Metrics

本文评价

[1]	马媛媛, 王燕, 宋琦, 陈克敏, 赵夏, 王黎, 江旭峰, 赵维莅, 严福华. 肺原发性淋巴瘤的CT影像学特点及文献复习[J]. 诊断学理论与实践, 2018, 17(05): 533-537.
[2]	董珂, 王鲁群,. 外周T细胞淋巴瘤的细胞和分子遗传学诊断[J]. 诊断学理论与实践, 2013, 12(02): 238-242.
[3]	侯明, 魏昱,. 外周T细胞淋巴瘤未特指型的诊断与治疗[J]. 内科理论与实践, 2011, 6(01): 16-21.