Re: [問題] 何杰金氏淋巴瘤 期中正子攝影報告

※ 引述《havesomefun (Handsome)》之銘言：
: 已經做了六次的化療(AVD+標靶)，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

延續一下之前自己問的問題

背景說明：
何杰金四期(頸部+肺部)
六個療程AVD+標靶 共12次

2/27做的期中正子醫生說已無照到癌細胞，後續仍把剩下的療程做完，五月初完成治療，並於7/27做了正子造影，詳細結果如最下方

醫生說肺部有一小亮點，但因為位置太過裡面，所以無法做切片(除非去外科麻醉切除化驗)，就安排我一個月後再回去追蹤照X光(上一次4/23照X光是正常)

醫生有詢問最近是否有出現像之前確診何杰金時的症狀，如咳嗽、有痰、發燒、皮膚癢等等，我是都沒有

也有詢問照正子的前兩天有運動(重訓)是否有影響到檢查結果，醫生是說沒影響

想請問這樣的結果是覆發的機率高嗎？現在最適當的選擇就是等追蹤了嗎？

醫生說一般何杰金不太會覆發，但因為是四期，所以也難說，唉… 又要開始擔心了

** 正子造影檢查結果：

** SCAN FINDINGS The level and distribution of radioactivity for 85A lymphomastaging:

1. Nodal regions Head/neck: not found (score 0) Axillary: not found (score 0)Thorax: not found (score 0) Abdominopelvis: not found (score 0)

2. Extranodal/organ involvement: Lungs: bilateral small lung nodules (SUV 5.5, score 4), new as compared with previous study on 2024/2/27. liver (score 0),spleen (score 0), GI tract (score 1), bone marrow (score 0)

3. other pertinent findings: not found (score 0) Impression: New bilateral small lung nodules, lymphoma relapse should be watched out.

* Deauville score: 4

Suggestion: Please correlate with clinical and other imaging findings.

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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