[問題] 何杰金氏淋巴瘤 期中正子攝影報告

[havesomefun (Handsome)]

已經做了六次的化療，並做了期中的正子攝影

可以幫我先看看病理報告嗎？ 之後就要回診了，好緊張


PROCEDURE for FDG Before whole body survey, the patient was required to fast
for at least 4 hours. Blood sugar level was measured 88 mg/dl. Then, 9.32 mCi
of 18F-FDG was injected intravenously. The patient was put into the scanner
in the ”arm-up” position, and the scan from vertex to mid thighs was
performed at 68 min. There was no immediately complication during the
procedure. The scan was adequate for interpretation.

** SCAN FINDINGS
The level and distribution of radioactivity for lymphoma response:
1. Nodal regions Head/neck: no more enlarged node (score 0) Axilla: (score 0)
Thorax: no more enlarged node (score 0) Abdomen/pelvis: (score 0)
2. Extranodal/organ involvement: Lungs (SUV 4.1, score 2)
3. other pertinent findings: Upper right back muscles (score 1) Bilateral rib
fractures (score 1) Impression: Hodgkin lymphoma initial stage IV with lung
involvement post 3 chemotherapy cycles, tiny focal uptake at LUL residual lung
opacity, could be residual disease or post-treatment inflammation. Other
lesions all distinguished, overall good metabolic response. * Deauville score:
2-3 (note that the timing is not at 2 cycles)

Comment:
1. FDG-PET scan might result in a false negative
finding if tumor size below 0.6 cm or tumors not FDG-avid.
2. Score 0 = normal; Score 1 = benign lesion; Score 2 = equivocal lesion;
Score 3 = possible malignancy; Score 4 = high probability of malignancy

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推 Mithra: 淋巴結的部分沒有看到病灶
→ Mithra: 肺有一顆（敘述看不出原本化療前的狀況） 他判level2（一
→ Mithra: 半一半的可能性）
→ Mithra: “Score 2”
這個是確診的時候做的正子報告


* PROCEDURE for FDG
Before whole body survey, the patient was required to fast for at least 4
hours. Blood sugar level was measured 11/23 09:54 97 mg/dl. Then, 9.97 mCi of
18F-FDG was injected intravenously. The patient was put into the scanner in the
”arm-up” position, and the scan from vertex to upper thighs was performed at
59 min. There was no immediately complication during the procedure. The scan
was adequate for interpretation.


** SCAN FINDINGS
The level and distribution of radioactivity for 85A lymphoma staging:
1. Nodal regions
Head/neck: Waldeyer”s (tonsil/nasopharynx) (score 0), right neck (SUVmax
8.6, score 4), left neck (SUVmax 2.7, score 3).
Axillary: right (SUVmax , score ), left (SUVmax , score ).
Thorax: anterior mediastinal (SUVmax 7.1, score 4), paratracheal (SUVmax
7.6, score 4), right hilar (score 0), left hilar (SUVmax 7.7, score 4),
subcarinal/posterior mediastinal (SUVmax 8.3, score 4), right internal mammary/
diaphragmatic (SUVmax 2.7, score 2), left internal mammary/diaphragmatic
(score 0).
bdomen: not found (score 0).

2. Extranodal/organ involvement:
Lungs: bilateral (SUVmax 11.6, score 4), liver (score 0), spleen (score 0),
kidneys (score 0), GI tract/specify (score 0), bone/bone marrow: right
lateral ribs (SUVmax 4.2, score 2)

3. other pertinent findings:
not found (score 0).


Impression:
1. Compatible with lymphoma involving the lymph node regions above the
diaphragm and bilateral lungs.

2. Mild right rib lesions, post-traumatic response was more likely.

* Lugano classificaton stage: IV



Suggestion:
 Nil.


Comment:
1. FDG-PET scan might result in a false negative finding if tumor size below
0.6 cm or tumors not FDG-avid.

2. Score 0 = normal; Score 1 = benign lesion; Score 2 = equivocal lesion;
Score 3 = possible malignancy; Score 4 = high probability of malignancy.


※ 編輯: havesomefun (1.171.89.175 臺灣), 03/15/2024 13:09:35
※ 編輯: havesomefun (1.171.89.175 臺灣), 03/15/2024 13:20:46
推 Mithra: 確診的時候肺兩邊都有（score 4)，這樣應該是進步