Abstract
The article shows the feasibility of detecting and monitoring primary breast diffuse large B-cell lymphoma using single-photon emission computed tomography (SPECT) with 99mTc-1-thio-D-glucose (99mТс-TG), a new radiopharmaceutical. The innovative radiopharmaceutical makes it possible to evaluate the metabolism of tumor tissue without using positron emission tomography. The findings of 99mTc-TG SPECT obtained during diagnosis and monitoring of the patient were confirmed by the results of computed tomography. A comprehensive examination of the patient, including 99mTc-TG SPECT, made it possible to diagnose a rare case of primary breast lymphoma. Primary breast lymphoma accounts for 1.7–2.2 % of all extranodal nonHodgkin lymphomas. Diffuse large B-cell lymphoma is the most common histological type occurring usually as a unilateral palpable tumor in middle-aged women. Extranodal lymphomas account for less than 0.5 % of all malignant neoplasms of the breast. After 6 courses of immunochemotherapy, the patient underwent 99mTc-TG SPECT, which demonstrated persistent hypermetabolic activity in the breast. The patient received radiation therapy to the remaining tumor of the left breast. The patient is in remission and followed up at the Cancer Research Institute of Tomsk National Research Medical Center. Thus, 99mTc-TG SPECT is believed to be a promising method for visualizing primary breast lymphomas and assessing their treatment outcomes. It is an alternative to the standard approach using 18F-FDG positron emission tomography. The method compares favorably with positron emission tomography with its wide availability and low cost of study.
Highlights
Диагностические возможности КТ ограничены при визуализации лимфатических узлов нормальных размеров, а также при наличии диффузного поражения печени, селезенки и костного мозга [5,6,7,8]
The innovative radiopharmaceutical makes it possible to evaluate the metabolism of tumor tissue without using positron emission tomography
The findings of 99mTc-TG single-photon emission computed tomography (SPECT) obtained during diagnosis and monitoring of the patient were confirmed by the results of computed tomography
Summary
Диагностические возможности КТ ограничены при визуализации лимфатических узлов нормальных размеров, а также при наличии диффузного поражения печени, селезенки и костного мозга [5,6,7,8]. В НИИ онкологии Томского НИМЦ проводится изучение возможности диагностики и оценки эффективности лечения злокачественных лимфом с новым РФП [11, 12]. По данным КТ, выполненной после 6 курсов лечения, отмечалось значительное уменьшение опухолевого образования в левой молочной железе 3. Компьютерная томограмма (аксиальный срез) пациентки с лимфомой левой молочной железы после 6 курсов терапии, отмечается значительное уменьшение опухоли Fig. 3. Принимая во внимание сохраняющуюся гиперметаболическую активность в патологическом очаге по данным ОФЭКТ с 99mTc-ТГ, с целью консолидации процесса был проведен курс дистанционной лучевой терапии на оставшуюся опухоль левой молочной железы, СОД 48 Гр (апрель 2019 г.). [Chernov V.I., Dudnikova E.A., Zelchan R.V., Kravchuk T.L., Danilova A.V., Medvedeva A.A., Sinilkin I.G., Bragina O.D., Goldberg V.E., Goldberg A.V., Frolova I.G. The first experience of using 99mTc-1-thio-d-glucose for singlephoton emission computed tomography imaging of lymphomas.
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