Tonsil non-Hodgkin lenfomalı hastaların değerlendirilmesinde FDG-PET/BT'nin değeri

Amaç: Bu çalışmanın amacı primer tonsil lenfomalarda FDG-PET/BT'nin evrelemedeki ve yeniden evrelemedeki değerini araştırmaktır. Gereç ve Yöntem: Merkezimizde FDG-PET/BT uygulanmış 29 tonsil lenfomalı hasta değerlendirildi. Yaş ortalaması 44 ± 20 yıl idi. Bu çalışmaya dahil edilen tüm hastalarda histopatolojik olarak tanı konmuştu. Hastalar, primer tümör bulguları evreleme, metabolic karakterizasyon ve yeniden evreleme yapıldı. Bulgular: Yirmidokuz hastanın 12'si kliniğimize evreleme, 17'si yeniden evreleme için yönlendirildi. Evreleme için müracaat eden 12 hastanın 5 tanesine tonsillektomi uygulanmış, geri kalan 7 tanesi ise henüz opere olmamıştı. PET/BT uygulaması öncesi tonsillektomi uygulanan hastaların beşinde de lenf nodu metastazı saptandı. Geri kalan 7 tane hastanın ise 5'inde tonsil ve beraberinde lenf nodu mestastazı saptanırken 2 tanesinde sadece tonsil tutulumu tespit edildi. Tedavi sonrası yeniden evreleme amacıyla FDG-PET/BT uygulanan 17 hastanın 7'sinde PET/BT negatif idi. Geri kalan 10 hastada lokal nüks ve lenfatik metastazlar saptandı. FDG-PET/BT'nin SUV maksimal değerlerinin ortalamaları sırasıyla marjinal zon lenfomalarda 5.5, Burkitt lenfomalarda 9.5 ve mikst sellüler tip lenfomalarda 7.6 olarak bulundu. Sonuç: FDG-PET/BT görüntüleme, primer ekstranodal lenfoma ve malignitelerin teshisinde evreleme ve tedaviye yanıtın değerlendirilmesinde değerli bir araçtır.

The value of FDG-PET/CT in the assessment of patients with non-Hodgkin's lymphoma of tonsil

Purpose: The purpose of this study is to evaluate the value of FDG-PET/CT in staging and re-staging tonsillar lymphoma.Materials and Methods: Twenty-nine patients with tonsillar lymphoma who had been evaluated with FDG-PET/CT in our center. The mean age was 44±20 years.The majority of patients presented with cervical lymphadenopathy. All patients included in this study were diagnosed on the basis of histopathology. Patients were indicated for primary tumor detection, metabolic characterization, staging, restaging and response to treatment.Results: Twelve patients out of 29 were referred to our clinic for staging and 17 were for restaging. Five patients presented primary focus in tonsils and lymph node metastasis. Two patients presented no metastasis and primary focus in tonsils only. The remaining five patients who had tonsillectomy prior to PET/CT presented lymph node metastasis. FDG-PET/CT for restaging was performed on 17 patients with tonsillectomy and / or chemoradiotherapy. Seven patients had negative PET/CT results revealing cure, others had local recurrence and lymphatic metastasis. SUV max values of FDG-PET/CT were found to be 11 and higher where as SUVmax in patients with marginal zone lymphoma, Burkitt's lymphoma and mixed cellular lymphoma were 5.5, 9.5 and 7.6, respectively.Conclusion: FDG-PET/CT imaging is a valuable tool for staging and as a follow-up modality for assessing the therapeutic response of patients suffering from primary extranodal lymphoma and in detecting malignancies.

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