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

Wenbin Yang
Wenbin Yang
, 
Sen Jiang
Sen Jiang
, 
Jianbang Lin
Jianbang Lin
 und 
Yangkang Li
Yangkang Li
   | 19. Jan. 2019
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Article Category: Research Article
Online veröffentlicht: 19. Jan. 2019
Seitenbereich: 31 - 38
Eingereicht: 28. Okt. 2018
Akzeptiert: 19. Dez. 2018
DOI: https://doi.org/10.2478/raon-2019-0005
© 2019 Wenbin Yang, Sen Jiang, Jianbang Lin, Yangkang Li published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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

Characteristics Number of cases Percentage(%)
Gender
Male 32 62.7
Female 19 37.3
Age(y) 47.8 ± 19.1 (range, 9–83)
Histology
PTCL-NOS 27 52.9
ALCL ALK+ 8 13.7
ALCL ALK- 7 15.7
AITL 9 17.6
Ann Arbor stage
I-II 21 41.2
III- IV 30 58.8
Clinical outcome
Progression or relapse within 24 months 27 52.9
No evidence of relapse within 24 months 24 47.1

CT findings of 51 patients with PTCL

Characteristics Number of cases Percentage(%)
Involvement site
Single 27 52.9
Multiple 24 47.1
Tumor size(cm) 6.0 ± 2.4 (range, 1.5–14.0)
Tumor margin
Well-defined 29 56.9
Ill-defined with peritumoral invasion 22 43.1
Tumor shape
Round/oval 17 33.3
Irregular 34 66.7
Tumor density
Homogenous 28 54.9
Heterogeneous 23 45.1
Intratumoral necrosis
Present 14 27.5
Absent 37 72.5
Enhancement degree
Mild 21 41.2
Moderate 30 58.8
Lymph node involvement
Present 32 62.7
Absent 19 37.3

Univariate analyses of CT findings

Factor Category Number of good vs poor outcomes P value
Involvement site 0.016*
Single 17:10
Multiple 7:17
Tumor size 0.328
< 6.0cm 14:13
≥ 6.0cm 10:14
Ill-defined margin with peritumoral invasion < 0.001*
Present 4:18
Absent 20:9
Tumor shape 0.617
Round/oval 8:9
Irregular 16:18
Inhomogenous density 0.001*
Present 5:18
Absent 19:9
Intratumoral necrosis 0.025*
Present 3:11
Absent 21:16
Enhancement degree 0.586
Mild 10:11
Moderate 14:16
Lymph node involvement 0.069
Present 12:20
Absent 12:7

Multivariate analyses of CT findings

Factor Odd ratio 95% CI P value
Involvement site 3.499 0.766–15.987 0.106
Ill-invasion defined margin with peritumoral 7.749 1.567–38.315 0.012*
Inhomogenous density 2.356 0.324–17.116 0.397
Intratumoral necrosis 3.157 0.253–39.370 0.372
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