PET/CT对合并慢性淋巴细胞白血病的高危前列腺癌患者淋巴结清扫的指导价值:1例报道
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摘要
患者,男性,70岁。2009年5月确诊为慢性淋巴细胞白血病,2018年3月因体检发现前列腺特异性抗原(prostate specific antigen,PSA)增高收治入院,诊断为高危前列腺癌。~(18)F-脱氧葡萄糖正电子发射计算机断层显像(~(18)F-FDG positron emission tomography/computed tomography,~(18)F-FDG-PET/CT)提示全身淋巴结肿大,糖代谢轻度升高,慢性淋巴细胞白血病可能。全雄激素阻断新辅助治疗1个月后行机器人辅助腹腔镜下根治性前列腺切除和右侧髂血管闭孔旁淋巴结活检术,术后病理结果提示前列腺癌,右髂血管闭孔旁淋巴结为慢性淋巴细胞白血病累及。术后1个月和3个月的PSA均达到根治水平。对于高危前列腺癌伴发慢性淋巴细胞白血病的患者,PET/CT可能对肿大淋巴结的判别有较高的价值,可用于指导前列腺癌手术中淋巴结的清扫。
A 70-year-old male with chronic lymphocytic leukemia(CLL) 9 years ago initially presenting elevation of prostate specific antigen(PSA) was diagnosed with high-risk prostate cancer in March, 2018. He received ~(18)F-FDG positron emission tomography/computed tomography(PET/CT), which showed mild FDG-avidity in swollen lymph nodes across the entire body, considering CLL. Then he underwent neoadjuvant androgen deprivation therapy for 1 month and then robot-assisted radical prostatectomy and biopsy of the right iliac vascular obturator lymph nodes. The prostate pathology was prostate cancer, and the pathology of lymph nodes was CLL. His serum PSA levels 1 month and 3 months after operation both reached the level of cure. For the patients with concomitant high-risk prostate cancer and CLL, PET/CT may be valuable in distinguishing whether the swollen lymph nodes were infiltrated by prostate cancer and guiding the lymphadenectomy.
A 70-year-old male with chronic lymphocytic leukemia(CLL) 9 years ago initially presenting elevation of prostate specific antigen(PSA) was diagnosed with high-risk prostate cancer in March, 2018. He received ~(18)F-FDG positron emission tomography/computed tomography(PET/CT), which showed mild FDG-avidity in swollen lymph nodes across the entire body, considering CLL. Then he underwent neoadjuvant androgen deprivation therapy for 1 month and then robot-assisted radical prostatectomy and biopsy of the right iliac vascular obturator lymph nodes. The prostate pathology was prostate cancer, and the pathology of lymph nodes was CLL. His serum PSA levels 1 month and 3 months after operation both reached the level of cure. For the patients with concomitant high-risk prostate cancer and CLL, PET/CT may be valuable in distinguishing whether the swollen lymph nodes were infiltrated by prostate cancer and guiding the lymphadenectomy.
引文
[1]Heidenreich A,Bastian PJ,Bellmunt J,et al.EAU guidelines on prostate cancer.PartⅡ:treatment of advanced,relapsing,and castration-resistant prostate cancer[J].Eur Urol,2014,65(2):467-479.
[2]中华医学会血液学分会白血病淋巴瘤学组,中国抗癌协会血液肿瘤专业委员会,中国慢性淋巴细胞白血病工作组.中国慢性淋巴细胞白血病/小淋巴细胞淋巴瘤的诊断与治疗指南(2018年版)[J].中华血液学杂志,2018,39(5):353-358.
[3]Tsimberidou AM,Wen S,Mc Laughlin P,et al.Other malignancies in chronic lymphocytic leukemiasmall lymphocytic lymphoma[J].J Clin Oncol,2009,7(6):904-910.
[4]Tomaszewski JM,Lau E,Corry J.Utility of positron emission tomography/computed tomography for nodal staging of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia[J].Am J Otolaryngol,2014,35(1):66-69.
[5]Li R,Ravizzini GC,Gorin MA,et al.The use of PET/CT in prostate cancer[J].Prostate Cancer Prostatic Dis,2018,21(1):4-21.
[2]中华医学会血液学分会白血病淋巴瘤学组,中国抗癌协会血液肿瘤专业委员会,中国慢性淋巴细胞白血病工作组.中国慢性淋巴细胞白血病/小淋巴细胞淋巴瘤的诊断与治疗指南(2018年版)[J].中华血液学杂志,2018,39(5):353-358.
[3]Tsimberidou AM,Wen S,Mc Laughlin P,et al.Other malignancies in chronic lymphocytic leukemiasmall lymphocytic lymphoma[J].J Clin Oncol,2009,7(6):904-910.
[4]Tomaszewski JM,Lau E,Corry J.Utility of positron emission tomography/computed tomography for nodal staging of cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia[J].Am J Otolaryngol,2014,35(1):66-69.
[5]Li R,Ravizzini GC,Gorin MA,et al.The use of PET/CT in prostate cancer[J].Prostate Cancer Prostatic Dis,2018,21(1):4-21.