PET/CT对乳腺癌术后肺结节病的诊断分析

PET/CT diagnosis of pulmonary sarcoidosis after breast cancer surgery

吴征瑜 ¹张碧云²

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作者信息

1. 200040 上海,复旦大学附属华山医院老年科
2. 210029 江苏南京,南京中医药大学附属医院江苏省中医院核医学科
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摘要

目的通过正电子发射计算机断层显像(PET/CT)的影像表现分析,以加强对乳腺癌术后结节病的认识,提高诊断及鉴别诊断能力.方法收集 2010 年—2023 年在复旦大学附属华山医院及江苏省中医院经病理证实的 28 例乳腺癌术后的结节病患者临床资料及PET/CT影像资料,回顾性分析其临床特点及PET/CT表现.结果 28 例患者诊断为结节病时的中位年龄 49 岁(38～75 岁),距离乳腺癌术后的中位时间为 4 年(1.5～7.8 年).乳腺癌术后病理均为浸润性乳腺癌,Ⅰ～Ⅱ期 26 例,Ⅲ期 2 例,其中 12 例行乳腺癌根治术,16 例行保乳手术.所有病例诊断为结节病前均未发生复发和转移,均为乳腺癌术后定期复查发现,无明确临床症状.PET/CT表现为双肺多发结节 18 例(64.2%),支气管血管束增粗 12例(42.6%),纵隔淋巴结肿大且放射性摄取增高 28 例(100%),双侧肺门淋巴结肿大且放射性摄取增高 26 例(92.9%),一侧肺门淋巴结肿大且放射性摄取增高 2 例(7.1%),腋窝淋巴结肿大且放射性摄取增高 9 例(32.1%),内乳淋巴结肿大且放射性摄取增高 2 例(7.1%).10 例表现椎旁胸膜的结节状增厚,放射性摄取增高(35.7%),均未见胸腔积液.胸外淋巴结且放射性摄取增高 16 例(57.1%),肝脏局限性放射性摄取增高 1 例(3.6%).结论乳腺癌术后结节病常模拟乳腺癌的淋巴结转移及肺转移的表现,充分认识结节病的PET/CT表现,尤其是胸外病变的识别,有利于提高结节病的诊断及与转移瘤的鉴别诊断能力.

Abstract

Objective To evaluate the diagnostic efficiency of 18F-fluorodeoxyglucose(FDG)positron emission tomography/computed tomography(PET/CT)in sarcoidosis after breast cancer surgery.Methods Clinical and FDG PET/CT data of 28 patients with pathologically confirmed sarcoidosis after breast cancer surgery in our hospital from 2010 to 2023 were retrospectively analyzed.Results The median age of the 28 patients at diagnosis of sarcoidosis was 49 years(38-75 years)and the median time from radical mastectomy(12)and breast-conserving surgery(16)for invasive breast cancer(26 stageⅠ-Ⅱ,2 stageⅢ)was 4 years(1.5-7.8 years).All patients were asymptomatic.No tumor recurrence or metastasis occurred before sarcoidosis was diagnosed on routine follow-up.PET/CT manifestations were FDG-avid mediastinal(28,100%),bilateral hilar(26,92.9%),unilateral hilar(2,7.1%),axillary(9,32.1%),internal mammary(2,7.1%),and/or external thoracic(16,57.1%)lymphadenopathy,multiple pulmonary nodules(18,64.2%),paratracheal thickening(12,42.6%),nodular thickening of paravertebral pleura(10,35.7%).No pleural effusion was observed.Increased localized hepatic uptake was seen in 1 patient(3.6%).Conclusion Sarcoidosis can mimic lymph node and lung metastasis after breast cancer surgery.PET/CT manifestations of extra-thoracic lesions can help to distinguish sarcoidosis from metastatic lesions.

关键词

乳腺癌/结节病/18/氟-氟代脱氧葡萄糖/正电子发射计算机断层显像

Key words

Breast cancer/Sarcoidosis/18F-fluorodeoxyglucose/Positron emission tomography/computed tomography

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基金项目

江苏省中医药局科技项目(JD201802)

上海市卫生健康委员会中医药科研项目(2024BJ005)

出版年

2024

影像诊断与介入放射学

中山大学

影像诊断与介入放射学

CSTPCD

影响因子：0.51

ISSN：1005-8001

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