Primary Hepatosplenic B-cell Lymphoma: linitial Diagnosis and Assessment of Therapeutic Response with F-18 FDG PET/CT

원발성 간비장 B세포성 림프종에서 치료전과 치료 후 F-18 FDG PET/CT 소견

  • Kang, Sung-Min (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Lee, Hong-Je (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Seo, Ji-Hyoung (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Lee, Sang-Woo (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Ahn, Byeong-Cheol (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Lee, Jae-Tae (Department of Nuclear Medicine, Kyungpook National University Hospital)
  • 강성민 (경북대학교 의과대학 핵의학교실) ;
  • 이홍제 (경북대학교 의과대학 핵의학교실) ;
  • 서지형 (경북대학교 의과대학 핵의학교실) ;
  • 이상우 (경북대학교 의과대학 핵의학교실) ;
  • 안병철 (경북대학교 의과대학 핵의학교실) ;
  • 이재태 (경북대학교 의과대학 핵의학교실)
  • Published : 2008.08.31

Abstract

A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT scan to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT scan was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules.1,2 Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity.3 The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT scan provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.

Keywords

References

  1. Kang KM, Chung WC, Lee KM, Hur SE, Nah JM, Back, JY, Kim SK, Yang JM, Choi HJ. A case of primary hepatic lymphoma mimicking. Korean J Hepatol 2005;11:284-8
  2. Harris AC, Ben-Ezra JM, Contos MJ, Kornstein MJ. Malignant lymphoma can present as hepatobiliary disease. Cancer 1996;78: 2011-9 https://doi.org/10.1002/(SICI)1097-0142(19961101)78:9<2011::AID-CNCR24>3.0.CO;2-Z
  3. Page RD, Romaguera JE, Osborne B, Medeiros LJ, Rodriguz J, North L, Sanz-Rodriguz C, Cabanillas F. Primary hepatic lymphoma: favorable outcome after combination chemotherapy. Cancer 2001; 92:2023-9 https://doi.org/10.1002/1097-0142(20011015)92:8<2023::AID-CNCR1540>3.0.CO;2-B
  4. Harris AC, Kornstein MJ. Malignant lymphoma imitating hepatitis. Cancer 1993;71:2639-46 https://doi.org/10.1002/1097-0142(19930415)71:8<2639::AID-CNCR2820710832>3.0.CO;2-Q