上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (4): 440-.doi: 10.3969/j.issn.1674-8115.2019.04.021

• 病例报告 • 上一篇    

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

朱寅杰，王艳青，潘家骅，董柏君，薛蔚   

  1. 上海交通大学医学院附属仁济医院泌尿科，上海 200127
  • 出版日期:2019-04-28 发布日期:2019-05-23
  • 通讯作者: 薛蔚，电子信箱：xuewei@renji.com。
  • 作者简介:朱寅杰（1986—），男，主治医师，硕士；电子信箱： zhuyinjie@renji.com。
  • 基金资助:
    上海交通大学医学院附属仁济医院临床科研创新培育基金（ PYII-17-005）

PET/CT for guidance of lymphadenectomy of high-risk prostate cancer in patients with chronic lymphocytic leukemia: 1 case report

ZHU Yin-jie, WANG Yan-qing, PAN Jia-hua, DONG Bai-jun, XUE Wei   

  1. Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2019-04-28 Published:2019-05-23
  • Supported by:
    Incubation Program for Clinical Research and Innovation of Renji Hospital, Shanghai Jiao Tong University School of Medicine, PYII-17-005

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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。 18F-脱氧葡萄糖正电子发射计算机断层显像（ 18F-FDG positron emission tomography/computed tomography， 18F-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。

关键词: 前列腺肿瘤, 慢性淋巴细胞白血病, 正电子发射计算机断层显像, 淋巴结清扫术

Abstract:

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 18F-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 infiltratedprostate cancer and guiding the lymphadenectomy. [Key words]prostate neoplasm; chronic lymphocytic leukemia; positron emission tomography/computed tomography; lymphadenectomy

Key words: prostate neoplasm, chronic lymphocytic leukemia, positron emission tomography/computed tomography, lymphadenectomy

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