Mucosa-Associated Lymphoid Tissue Lymphoma: Correlation Between Imaging Diagnosis With Pathology

Part I Diagnostic Value and Influencing Factors of 18F-FDG PET / CT in Mucosa-associated Lymphoid Tissue Lymphoma[Objective]To investigate the diagnostic value of 18F-FDG PET/CT in mucosa-associated lymphoid tissue lymphoma and the influencing factors of 18F-FDG uptaked by tumor tissue.[Materials and Methods]Retrospectively analyzed the clinical datas of 57 patients with pathological confirmed for mucosa-associasted lymphoid tissue(MALT) lymphoma, including stomach in 37 cases, 7 cases of thyroid, 5 cases of pulmonary, 3 cases of orbit, 2 cases of parotid. The sensitivity of PET / CT was analyzed, and the patients were divided according as sex, age, location, stage and lesion morphology to compare the difference of FDG affinity between the two groups.Moreover, we analyzed the difference of SUVmax according as the involved sites, the expression of Ki-67 according as the adivity of FDG, and the correlation between SUVmax with the expression of Ki-67. SPSS17.endO software was used for statistical analysis.Chi-square test , Fisher's exact tests were used, t test and Person correlation analysis were used. The test level was 0.05.[Results]54 cases were all primary tumors. 11 patients were diagnosed by biopsy,of which, 8 patients were diagnosed by endoscopic biopsy, 2 patients were diagnosed by biopsy under nasal biopsy. 1 patient underwent CT-guided biopsy of lung biopsy. Another 43 patients were confirmed by surgical pathology. Among 54 primary lesions, 24 (44.4%, 24/54) lesions were highly affinitive with FDC, and FDG affinity (24.3%,9/37) was significantly lower in gastric mucosa-associated lymphoma Stomach (88.2%, 15/17) FDG affinity, P <0.001. The FDG affinity (91.7%, 22/24) was significantly higher than that in the mucosa (6.7%, 2/30), P<0.001, and the FDG affinity (87.5%, 7/8) was significantly higher than that in mucosal superficial lesions (6.9%,2/29),P <0.001. (Age ? 44 years,37.9 ± 5.1),middle age group (45 to 59 years old,49.2 ± 3.5), elderly group (?60 years old,66.2 ± 4.7),different age (according to the age of the United Nations age group (25 males and 29 females). There was no significant difference in FDG uptake rate between early stage (I and?) and advanced (? and ?). The expression of Ki-67 in FDG high affinity group was significantly higher than that in FDG group (t = 7.451, P <0.001). There was no significant correlation between SUVmax and Ki-67.[Conclusion] This study shows that the FDG affinity of mucosal-associated lymphoid tissue lymphoma varies with the location and morphology of the lesion, and the FDG affinity of the non-gastric nodule mass is higher, and the majority of gastric mucosal lesions FDG affinity is poor.Part ? the Influencing Factors of Diagnosis and Prognostic Value of 18F-FDG PET / CT in Gastric Mucosa-associated Lymphoid Tissue Lymphoma[Objective]To investigate the influencing factors of 18F-FDG affinity in gastric MALT lymphoma and the prognostic value of 18F-FDG PET / CT in gastric MALT lymphoma.[Materials and Methods ]The clinical data, pathologic data, follow - up data and 18F - FDG PET / CT results of 37 cases of gastric mucosa - associated lymphoid tissue lymphoma confirmed by pathology were retrospectively analyzed. Analysis of the sensitivity of PET / CT diagnosis. The patients were divided into two groups according to their sex, age, clinical stage, plasma cell differentiation and Helicobacter pylori infection. The difference of FDG affinity between the two groups was analyzed. Moreover, we analyzed the difference of the lesion size and progression-free survival according to FDG adivity. Statistical analysis of SUVmax and tumor proliferation index Ki-67 expression is related. SPSS17.endO software was used for statistical analysis. FDG differences between groups were tested by Fisher exact test. The correlation between SUVmax and Ki-67 was tested by Person correlation analysis. Log-rank test was used to analyze whether there was no difference in progression-free survival between different groups. The test level was 0.05..[Results]9 patients with gastric mucosa-associated lymphoid tissue lymphoma (24.3%) showed FDG high affinity,ie,FDG uptake. According to Musshoff staging, 31 patients were I, 3 patients were II, and 3 were III. (61.5%, 8/13) FDG affinity was significantly higher than that in plasma-free tumors (4.2%, 1/24), P <0.001. FDG affinity between different groups of tumor size was statistically different (t = -3.33, P = 0.008). (Age ? 36 years, 36.3 ± 6.7),middle age group (45-59 years old,50.1 ± 4.5),elderly group (?60 years old,67.1 ±4.9), different gender (30 cases, 20 males, 17 femaless), early stage (I and II) and late stage(III and IV), Helicobacter pylori positive patients (23 cases) and negative patients (14 cases)FDG affinity between no significant statistics Differences in learning. There was a significant difference in Ki-67 expression between different groups (t = -5.48, P <0.001). There was a correlation between SUVmax and expression rate of Ki67 (correlation coefficient = 0.818, P?0.007). There was a statistically significant difference in the progression-free survival curves between different groups (? = 11.39, P <0.001).[Conclusion]FDG affinity of gastric mucosa-associated lymphoid tissue lymphoma is related to tumor plasma cell size and tumor size. SUVmax is related to Ki67 expression rate and can reflect the proliferation ability of tumor to a certain extent. the progression-free survival rate according the FDG affinity is different.Part ? the Correlation between Imaging Findings of Primary Pulmonary Lymphoma with Pathology[Objective]To study the CT findings of primary pulmonary lymphoma (PPL) and the correlation between the CT features with pathology.[Materials and Methods]We retrospectively analysis the CT findings and pathology of 72 pretreatment patients were seen who had pathologic diagnose of PPL from 2007 to 2016 in our hospital.[Results]56 patients were diagnosed with MALToma;8 patients were diagnosed with diffuse large B cell lymphoma;3 patients were diagnosed with Hodgkins lymphoma; 1 patient was diagnosed with intravascular lymphoma,4 patients were diagnosed with T cell lymphoma. We classified them into two divisions: MALT-oma and non-MALToma, given their different grade of malignancy. Patients were classified as having following five patterns : (1) nodular or mass-like involvement pattern was seen in 32 patients (21 MALTomas, 11 non-MALTomas);(2) lobar or segmental involvement pattern in 7patients (6 MALTomas, 1 non-MALTomas);(3) bronchovascular bundles distribution pattern in 11 patients(10 MALTomas,l non-MALTomas); (4) DILD pattern in 3 patients(2 MALTomas ,1 non-MALToma); (5) mixed pattern in 19 patients(17 MALTomas,2 non-MALTomas). Bronchogram sign was observed in 46 patients(42 MALTomas,4 non-MALTomas);angiogram sign in 38 patients(36 MALTomas,2 non-MALTomas); halo sign in 14 patients(7 MALTomas,7 non-MALTomas),cross lobar sign in 14 patients (12 MALTomas,2 non-MALTomas), butterfly sign in 4 patients( 4 MALTomas,0 non-MALToma). In addition, bronchogram sign and angiogram signoccurred significantly more often in MALToma than non-MALToma (P<0.05) ; halo signoccurred more often in MALToma than MALToma (P< 0.05). Butterfly sign is the most CT feature of PPL.[Conclusion]The CT performance of PPL is diverse. The specific signs, such as air bronchogram sign,CT angiogram sign, halo sign, butterfly sign and cross leaf distribution contribute to the differential diagnosis.The distribution of CT features in different pathologic type of PPL have discrepancy given malignant grade.