淋巴瘤患儿化疗后反跳性（反应性）胸腺增生

淋巴瘤患儿化疗后反跳性（反应性）胸腺增生

Rebound (reactive) thymic hyperplasia after chemotherapy in children with lymphoma

前言：儿童淋巴瘤患者化疗后胸腺再生已报道，为避免误诊为复发，医生应熟悉反弹（反应性）胸腺增生（RTH），并注意其可能发生。我们旨在评估化疗结束后儿童淋巴瘤患者的RTH患病率，并评估其临床特点、结果以及CT和镓-67（GA-67）扫描的结果。

患者和方法：我们回顾性的横断面研究，回顾了在沙特阿拉伯吉达的儿科肿瘤门诊管理的诊断为淋巴瘤儿童的健康记录。

结果：51.9%淋巴瘤患者（14/27）出现胸腺反弹性增生。化疗结束后，其平均时间为2.5个月（范围2.0-4.25个月）。RTH患者的治疗时间明显缩短，在性别、诊断年龄、淋巴瘤类型或治疗类型等方面，RTH患者的治疗时间均无显著性差异。所有RTH患者均无症状，常规实验室检查未发现异常。CT和GA-67扫描结果提示RTH的发生。RTH患者均无复发，RTH在6个月的中位数内自发消退（范围4.0-11.0）。

结论：50%的儿童化疗结束后，检测到RTH。临床评估和实验室试验结合CT和GA-67成像可以帮助识别RTH，排除其他病变。

关键词：儿童淋巴瘤；计算机断层扫描；镓-67扫描；反弹/反应性胸腺增生

Introduction: Thymic regrowth after chemotherapy treatment has been reported in children with lymphoma, and in order to avoid misdiagnosing these cases as relapses, physicians should become familiar with rebound (reactive) thymic hyperplasia (RTH) and remain aware of its possible occurrence. We aimed to estimate the prevalence of RTH in children with lymphoma after completion of chemotherapy and to evaluate the clinical characteristics, outcomes, and the findings of computed tomography (CT) and gallium-67 (GA-67) scans in these patients.

Patients and methods: We conducted a retrospective cross-sectional study by reviewing the health records of children with a lymphoma diagnosis managed at an outpatient paediatric oncology clinic in Jeddah, Saudi Arabia.

Results: Rebound thymic hyperplasia was detected in 51.9% of the lymphoma patients (14/27). It developed a median of 2.5 months after completion of chemotherapy (range, 2.0-4.25 months). Patients with RTH had significantly shorter treatment durations, and we found no significant differences between patients with and without RTH in sex, age at diagnosis, type of lymphoma or type of treatment received. All patients with RTH were asymptomatic, and routine laboratory tests did not detect any abnormalities in them. The findings of CT and GA-67 scans were highly suggestive of RTH. None of the patients with RTH had a recurrence, and RTH resolved spontaneously within a median of 6 months (range, 4.0-11.0).

Conclusion: RTH was detected in ∼50% of children with lymphoma after completion of chemotherapy. A clinical evaluation and laboratory tests combined with imaging by CT and GA-67 can help identify RTH and rule out other lesions elsewhere.

Keywords: Childhood lymphoma; Computed tomography; Gallium-67 scan; Gammagrafía con galio-67; Hiperplasia tímica de rebote; Linfoma infantil; Rebound/reactive thymic hyperplasia; Tomografía computarizada.