脾多发性血管淋巴管瘤18F-FDG PET/CT显像一例
Chinese Journal of Nuclear Medicine and Molecular Imaging(2018)
Abstract
患者女,25 岁,既往体健,1 个月前体格检查发现脾占位,无恶心呕吐,无腹痛腹胀,无畏寒发热,无咳嗽咳痰,无胸闷气喘,无呕血黑便,皮肤无瘀点瘀斑,无贫血貌,无肉眼血尿,血常规、血生化、血红细胞沉降率及肿瘤标志物未见异常. 腹部 MRI(图 1)示脾肿大伴多发占位,脾多发性血管淋巴管瘤可能;淋巴瘤或其他待排. PET/ CT 显像(图 2)示脾增大,脾内多发边界不清类圆形低密度影,部分病灶伴18 F-脱氧葡萄糖(fluorodeoxyglucose, FDG)代谢略增高,考虑低代谢肿瘤. 后行腹腔镜脾切除术,手术探查腹腔:腹腔内无腹腔积液,胃、小肠、结肠术中均未见异常,肝脏大小、质地正常,胆囊大小约 8 cm×4 cm,脾约 20 cm×15 cm×10 cm 大小,副脾约 3 cm×3 cm 大小,术中诊断为脾肿瘤、副脾,遂行腹腔镜下脾切除术+副脾切除术. 术后病理(图 3)示:脾内脉管增生,管腔扩张,大小不一,内容红细胞及淋巴液. 结论:脾多发性血管淋巴管瘤.
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Cardiac Imaging
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