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CT findings predict survival of patients with peripheral T cell lymphoma: a preliminary study Cover

CT findings predict survival of patients with peripheral T cell lymphoma: a preliminary study

Radiology and Oncology
Volume 53 (2019): Issue 1 (March 2019)
By: Wenbin Yang,  Sen Jiang,  Jianbang Lin and  Yangkang Li  
Open Access
|Jan 2019

Figures & Tables

Figure 1

A 13-year-old boy with PTCL in the anterior mediastinum. (A) Axial non-contrast CT image shows an oval, well-defined mass with homogeneous density in the anterior mediastinum (white arrow). (B) Contrast-enhanced CT image shows the tumor with homogeneously mild enhancement (white arrow). Tumor recurrence was not noted during the 36-month follow-up period.
A 13-year-old boy with PTCL in the anterior mediastinum. (A) Axial non-contrast CT image shows an oval, well-defined mass with homogeneous density in the anterior mediastinum (white arrow). (B) Contrast-enhanced CT image shows the tumor with homogeneously mild enhancement (white arrow). Tumor recurrence was not noted during the 36-month follow-up period.

Figure 2

A 54-year-old man with PTCL in the sinonasal cavity. (A) Axial non-contrast CT image shows an ill-defined, irregular mass with inhomogeneous density in the right nasal cavity, maxillary and sphenoid sinus (black arrows). (B) Contrast-enhanced CT image shows the tumor with heterogeneously moderate enhancement. Intratumoral necrosis is seen in the mass (black arrow). (C) Bony destruction is detected on non-contrast CT image. The tumor relapsed 11 months after therapy.
A 54-year-old man with PTCL in the sinonasal cavity. (A) Axial non-contrast CT image shows an ill-defined, irregular mass with inhomogeneous density in the right nasal cavity, maxillary and sphenoid sinus (black arrows). (B) Contrast-enhanced CT image shows the tumor with heterogeneously moderate enhancement. Intratumoral necrosis is seen in the mass (black arrow). (C) Bony destruction is detected on non-contrast CT image. The tumor relapsed 11 months after therapy.

Figure 3

A 47-year-old man with PTCL in the anterior mediastinum. (A) Axial non-contrast CT image shows an ill-defined, irregular mass with inhomogeneous density in the anterior mediastinum (black arrow). Multiple pleural metastases are detected (white arrows). (B) Contrast-enhanced CT image shows the tumor with heterogeneously mild enhancement. Intratumoral necrosis is seen in the mass (black arrow). Lymphadenopathy is seen in the left axillary fossa (white arrows). (C, D, E) The left internal jugular vein is invaded by the tumor and vessel occlusion is detected on contrast-enhanced CT image and MPR images (white arrows). Tumor progression was found during therapy. This patient deceased at 3 months after therapy.
A 47-year-old man with PTCL in the anterior mediastinum. (A) Axial non-contrast CT image shows an ill-defined, irregular mass with inhomogeneous density in the anterior mediastinum (black arrow). Multiple pleural metastases are detected (white arrows). (B) Contrast-enhanced CT image shows the tumor with heterogeneously mild enhancement. Intratumoral necrosis is seen in the mass (black arrow). Lymphadenopathy is seen in the left axillary fossa (white arrows). (C, D, E) The left internal jugular vein is invaded by the tumor and vessel occlusion is detected on contrast-enhanced CT image and MPR images (white arrows). Tumor progression was found during therapy. This patient deceased at 3 months after therapy.

Figure 4

A 61-year-old man with PTCL in the deudenum. (A) Axial non-contrast CT image shows the thickening of the duodenal wall (white arrows).The lesion grows in an expansive centripetal fashion (black arrow) with an ill-defined margin and invasion of adjacent fatty tissue (thin black arrow). (B) Contrast-enhanced CT image shows the tumor with heterogeneously mild enhancement. Superior mesenteric artery and vein are encased by the tumor (white arrows). Tumor progression was found during therapy. This patient deceased at 5 months after therapy.
A 61-year-old man with PTCL in the deudenum. (A) Axial non-contrast CT image shows the thickening of the duodenal wall (white arrows).The lesion grows in an expansive centripetal fashion (black arrow) with an ill-defined margin and invasion of adjacent fatty tissue (thin black arrow). (B) Contrast-enhanced CT image shows the tumor with heterogeneously mild enhancement. Superior mesenteric artery and vein are encased by the tumor (white arrows). Tumor progression was found during therapy. This patient deceased at 5 months after therapy.

Clinical characteristics of 51 patients with PTCL

CharacteristicsNumber of casesPercentage(%)
Gender
Male3262.7
Female1937.3
Age(y)47.8 ± 19.1 (range, 9–83)
Histology
PTCL-NOS2752.9
ALCL ALK+813.7
ALCL ALK-715.7
AITL917.6
Ann Arbor stage
I-II2141.2
III- IV3058.8
Clinical outcome
Progression or relapse within 24 months2752.9
No evidence of relapse within 24 months2447.1

CT findings of 51 patients with PTCL

CharacteristicsNumber of casesPercentage(%)
Involvement site
Single2752.9
Multiple2447.1
Tumor size(cm)6.0 ± 2.4 (range, 1.5–14.0)
Tumor margin
Well-defined2956.9
Ill-defined with peritumoral invasion2243.1
Tumor shape
Round/oval1733.3
Irregular3466.7
Tumor density
Homogenous2854.9
Heterogeneous2345.1
Intratumoral necrosis
Present1427.5
Absent3772.5
Enhancement degree
Mild2141.2
Moderate3058.8
Lymph node involvement
Present3262.7
Absent1937.3

Univariate analyses of CT findings

FactorCategoryNumber of good vs poor outcomesP value
Involvement site 0.016*
Single17:10
Multiple7:17
Tumor size 0.328
< 6.0cm14:13
≥ 6.0cm10:14
Ill-defined margin with peritumoral invasion < 0.001*
Present4:18
Absent20:9
Tumor shape 0.617
Round/oval8:9
Irregular16:18
Inhomogenous density 0.001*
Present5:18
Absent19:9
Intratumoral necrosis 0.025*
Present3:11
Absent21:16
Enhancement degree 0.586
Mild10:11
Moderate14:16
Lymph node involvement 0.069
Present12:20
Absent12:7

Multivariate analyses of CT findings

FactorOdd ratio95% CIP value
Involvement site3.4990.766–15.9870.106
Ill-invasion defined margin with peritumoral7.7491.567–38.3150.012*
Inhomogenous density2.3560.324–17.1160.397
Intratumoral necrosis3.1570.253–39.3700.372
DOI: https://doi.org/10.2478/raon-2019-0005 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 31 - 38
Submitted on: Oct 28, 2018
|
Accepted on: Dec 19, 2018
|
Published on: Jan 19, 2019
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
lymphoma,
peripheral T cell lymphoma,
computed tomography,
prognosis
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2019 Wenbin Yang, Sen Jiang, Jianbang Lin, Yangkang Li, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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