Diffuse Bone Marrow Uptake of $^{99m}$Tc-MIBI in A Case of Intravascular Large B-cell Lymphoma

혈관내 B 대세포 림프종 환자에서 발견된 $^{99m}$Tc-MIBI의 미만성 골수 섭취

  • Moon, Seung-Hwan (Department of Nuclear Medicine, Seoul National University College of Medicine) ;
  • Oh, So-Won (Department of Nuclear Medicine, Seoul National University College of Medicine) ;
  • Paeng, Jin-Chul (Department of Nuclear Medicine, Seoul National University College of Medicine) ;
  • Paik, Jin-Ho (Department of Pathology, Seoul National University College of Medicine) ;
  • Lee, Dong-Soo (Department of Nuclear Medicine, Seoul National University College of Medicine)
  • 문승환 (서울대학교 의과대학 핵의학교실) ;
  • 오소원 (서울대학교 의과대학 핵의학교실) ;
  • 팽진철 (서울대학교 의과대학 핵의학교실) ;
  • 백진호 (서울대학교 의과대학 병리학교실) ;
  • 이동수 (서울대학교 의과대학 핵의학교실)
  • Published : 2009.08.30

Abstract

Intravascular large B-cell lymphoma (IVLBCL) is a subtype of diffuse large cell lymphoma, characterized by proliferation of lymphoid cells in the intravascular space of various organs without causing a mass effect. Although $^{18}$F-FDG PET is a powerful imaging tool in lymphoma, the usefulness of $^{18}$F-FDG PET in the assessment of IVLBCL is still controversial. $^{99m}$Tc-MIBI, a tumor imaging radiopharmaceutical with a different mechanism from that of $^{18}$F-FDG, has been reported to be also effective in lymphoma. However, there is nearly no report on the efficacy of $^{99m}$Tc-MIBI in the assessment of IVLBCL. We present one case of IVLBCL that showed $^{99m}$Tc-MIBI accumulation in the involved bone marrow as an incidental finding, which was discrepant from that of $^{18}$F-FDG PET.

Keywords

References

  1. Lapkuviene O, Forchetti D, Roepke JE. Unusual sites of involvement by hematologic malignancies. Case 1: intravascular large B-cell lymphoma presenting with CNS symptoms. J Clin Oncol 2001; 19:3988-91 https://doi.org/10.1200/JCO.2001.19.19.3988
  2. Garter KC, Warnke RA. Intravascular large B-cell lymphoma. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, editors. World Health Organization: pathology and genetics of tumors of haematopoietic and lymphoid tissues. Lyon: IARC; 2001. p. 177-8
  3. Ponzoni M, Ferreri AJ, Campo E, Facchetti F, Mazzucchelli L, Yoshino T, et al. Definition, diagnosis, and management of intravascular large B-cell lymphoma: proposals and perspectives from an international consensus meeting. J Clin Oncol 2007;25:3168-73 https://doi.org/10.1200/JCO.2006.08.2313
  4. Demirer T, Dail DH Aboulafia DM. Four varied cases of intravascular lymphomatosis and a literature review. Cancer 1994;73:1738-45 https://doi.org/10.1002/1097-0142(19940315)73:6<1738::AID-CNCR2820730631>3.0.CO;2-U
  5. Satti S, Castillo R Intravascular B-cell lymphoma. Commun Oncol 2005;2:55-60 https://doi.org/10.1016/S1548-5315(11)70849-X
  6. Odawara J, Asada N, Aoki T, Yamakura M, Takeuchi M, Ohuchi T, et al. $^{18}$F-Fluorodeoxyglucose positron emission tomography for evaluation of intravascular large B-cell lymphoma. Br J Haematol 2007;136:684 https://doi.org/10.1111/j.1365-2141.2006.06414.x
  7. Lannoo L, Smets S, Steenkiste E, Delforge M, Moerman P, Stroobants S, et al. Intravascular large B-cell lymphoma of the uterus presenting as fever of unknown origin (FUO) and revealed by FDG-PET. Acta Clin Belg 2007;62:187-90 https://doi.org/10.1179/acb.2007.031
  8. Hoshino A, Kawada E, Ukita T, Itoh K, Sakamoto H, Fujita K, et al. Usefulness of FDG-PET to diagnose intravascular lymphomatosis presenting as fever of unknown origin. Am J Hematol 2004;76:236-9 https://doi.org/10.1002/ajh.20099
  9. Hofman MS, Fields P, Yung L, Mikhaeel NG. Ireland R, Nunan T. Meningeal recurrence of intravascular large B-cell lymphoma: early diagnosis with PET-CT. Br J Haematol 2007;137:386 https://doi.org/10.1111/j.1365-2141.2007.06551.x
  10. Murase T, Yamaguchi M, Suzuki R, Okamoto M, Sato Y, Tamaru J, et al. Intravascular large B-cell lymphoma (IVLBCL): a clinicopathologic study of 96 cases with special reference to the immlU1ophenotypic heterogeneity of CD5. Blood 2007;109:478-85 https://doi.org/10.1182/blood-2006-01-021253
  11. Gill S, Melosky B, Haley L, Chan Yan C. Use of random skin biopsy to diagnose intravascular lymphoma presenting as fever of unknown origin. Am J Med 2003;114:56-8 https://doi.org/10.1016/S0002-9343(02)01378-5
  12. Asada N, Odawara J, Kimura S, Aoki T, Kamakura M, Takeuchi M, et al. Use of random skin biopsy for diagnosis of intravascular large B-cell lymphoma. Mayo Clin Proc 2007;82:1525-7 https://doi.org/10.4065/82.12.1525
  13. Shimada K, Kosugi H, Shimada S, Narimatsu H, Koyama Y, Suzuki N, et al. Evaluation of organ involvement in intravascular large B-cell lymphoma by $^{18}$F-fluorodeoxyglucose positron emission tomography. Int J Hematol 2008;88: 149-53 https://doi.org/10.1007/s12185-008-0102-7
  14. Lazarowski A, Dupont J, Fernandez J, Garay G, Florin A, Solimano J, et al. $^{99m}$Technetium-SESTAMIBI uptake in malignant lymphomas. Correlation with chemotherapy response. Lymphat Res Biol 2006;4:23-8 https://doi.org/10.1089/lrb.2006.4.23
  15. Maurea S, Acampa W, Varrella P, De Rosa V, Fimiani P, Abate G, et al. Tc-99m sestamibi imaging in the diagnostic assessment of patients with lymphomas: comparison with clinical and radiological evaluation. Clin Nucl Med 1998;23:283-90 https://doi.org/10.1097/00003072-199805000-00004
  16. Ziegels P, Nocaudie M, Huglo D, Deveaux M, Detourmignies L, Wattel E, et al. Comparison of technetium-99m methoxyisobuty-lisonitrile and gallium-67 citrate scanning in the assessment of lymphomas. Eur J Nucl Med 1995;22:126-31 https://doi.org/10.1007/BF00838942
  17. Yanagihori H, Oyama N, Kawakami Y, Sakuma-Oyama Y, Nakamura K, Iwatsuki K, et al. A case of intravascular large B-cell lymphoma with multiple organ involvement. J Dermatol 2003;30:910-14 https://doi.org/10.1111/j.1346-8138.2003.tb00347.x
  18. Lui PCW, Wong GKC, Poon WS, Tse GMK. Intravascular lymphomatosis. J Clin Pathol 2003;56:468-70 https://doi.org/10.1136/jcp.56.6.468
  19. Wong M, Evans S, Rivory LP, Hoskins JM, Mann GJ, Farlow D, et al. Hepatic technetium Tc 99m-labeled sestamibi elimination rate and ABCB1 (MDR1) genotype as indicators of ABCB1 (P-glycoprotein) activity in patients with cancer. Clin Pharmacol Ther 2005;77:33-42 https://doi.org/10.1016/j.clpt.2004.09.002
  20. Fujii H, Nakamura K, Kubo A, Enomoto K, Ikeda T, Kubota T, et al. $^{99m}$Tc-MIBI scintigraphy as an indicator of the chemosensitivity of anthracyclines in patients with breast cancer. Anticancer Res 1998;18:4601-5