Abstract
We present a case of a 23 year-old male treated for Hodgkin’s lymphoma who developed diffuse large B-cell lymphoma (DLBCL) 8 years after achieving remission. 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET-CT) was done, which revealed extensive extranodal involvement of bilateral atria, bilateral kidneys, ileo-caecal junction and left testis along with mesenteric and retroperitoneal lymph nodal involvement. Renal and cardiac lesions were not detected by contrast-enhanced CT. Simultaneous lymphomatous involvement of rare sites such as heart, kidneys and testis in a single patient has not been reported before.
References
Armitage JO, Longo DL. Malignancies of lymphoid cells. In: Kasper DL, Braunwald E, Fauci AS, et al., editors. (15): Harrison’s principles of Internal Medicine. New York: The McGraw-Hill Companies; 2005. p. 641–55.
Paes FM, Kalkanis DG, Sideras PA, Serafini AN. FDG PET/CT of Extranodal Involvement in Non-Hodgkin Lymphoma and Hodgkin Disease. RadioGraphics. 2010;30:269–91.
Even-Sapir E, Lievshitz G, Perry C, Herishanu Y, Lerman H, Metser U. Fluorine-18 Fluorodeoxyglucose PET/CT Patterns of Extranodal Involvement in Patients with Non-Hodgkin Lymphoma and Hodgkin’s Disease. Radiol Clin N Am. 2007;45:697–709.
Pelosi E, Pregno P, Penna D, Deandreis D, Chiappella A, Limerutti G, et al. Role of whole-body [18F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and conventional techniques in the staging of patients with Hodgkin and aggressive non Hodgkin lymphoma. Radiol Med. 2008;113:578–90.
Kumar R, Maillard I, Schuster SJ, Alavi A. Utility of fluorodeoxyglucose-PET imaging in the management of patients with Hodgkin’s and non-Hodgkin’s lymphomas. Radiol Clin North Am. 2004;42:1083–100.
Jerusalem G, Bequin Y, Fassotte MF, Najjar F, Paulus P, Rigo P, et al. Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood. 1999;15:429–33.
Specht L. 2-[18F]fluoro-2-deoxyglucose positron-emission tomography in staging, response evaluation, and treatment planning of lymphomas. Semin Radiat Oncol. 2007;17:190–7.
Yin Y, Qing F, Li X, Du B, Li N, Li Y. Non Hodgkin’s lymphoma of the testicle and bilateral adrenals detected by 18F-FDG PET/CT. Exp Theor Med. 2011;2:817–20.
Julian A, Wagner T, Ysebaert L, Chabbert V, Payoux P. FDG PET/CT leads to the detection of metastatic involvement of the heart in non-Hodgkin’slymphoma. Eur J Nucl Med Mol Imaging. 2011;38:1174.
Kaderli AA, Baran I, Aydin O, Bicer M, Akpinar T, Ozkalemkas F, et al. Diffuse involvement of the heart and great vessels in primary cardiac lymphoma. Eur J Echocardiogr. 2010;11:74–6.
Su HY, Huang HL, Sun CM, Hou SM, Chen ML. Primary cardiac lymphoma evaluated with integration of PET/CT and contrast-enhanced CT. Clin Nucl Med. 2009;34:298–301.
d’Amore F, Christensen BE, Brincker H, Pedersen NT, Thorling K, Hastrup J, et al. features and prognostic factors in extranodal non-Hodgkin lymphomas. Danish LYFO Study Group. Eur J Cancer. 1991;27:1201–8.
Economopoulos T, Asprou N, Stathakis N, Papageorgiou E, Dervenoulas J, Xanthaki K, et al. Primary extranodal non-Hodgkin’s lymphoma in adults: clinicopathological and survival characteristics. Leuk Lymphoma. 1996;21:131–6.
Lopez-Guillermo A, Colomo L, Jimenez M, Bosch F, Villamor N, Arenillas L, et al. Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin. J Clin Oncol. 2005;23:2797–804.
Economopoulos T, Papageorgiou S, Rontogianni D, Kaloutsi V, Fountzilas G, Tsatalas C, et al. Multifocal Extranodal Non-Hodgkin Lymphoma: α clinicopathologic study of 37 Cases in Greece, a Hellenic Cooperative Oncology Group Study. Oncologist. 2005;10:734–8.
Moller MB, Pedersen NT, Christensen BE. Diffuse large B-cell lymphoma: clinical implications of extranodal versus nodal presentation—a population-based study of 1575 cases. Br J Haematol. 2004;124:151–9.
Levine MS, Rubesin SE, Pantongrag-Brown L, Buck JL, Herlinger H, et al. Non-Hodgkin’s lymphoma of the gastrointestinal tract: radiographic findings. AJR Am J Roentgenol. 1997;168:165–72.
Heiken JP, Gold RP, Schnur MJ, King DL, Bashist B, Glazer HS. Computed tomography of renal lymphoma with ultrasound correlation. J Comput Assist Tomogr. 1983;7:245–50.
Sheth S, Ali S, Fishman E. Imaging of renal lymphoma: patterns of disease with patholgioc correlation. RadioGraphics. 2006;26:1151–68.
Villa D, Connors JM, Sehn LH, Gascoyne RD, Savage KJ. Diffuse large B-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse. Haematologica. 2011;96:1002.
Guermazi A, Brice P, de Kerviler EE, Fermé C, Hennequin C, Meignin V, et al. Extranodal Hodgkin disease: spectrum of disease. RadioGraphics. 2011;21:161–79.
van den Bos EJ, Baks T, Bakker J, van Gelder W, Levin MD. Severe right ventricular inflow obstruction by non-Hodgkin lymphoma. Br J Haematol. 2008;142:858.
Leite NP, Kased N, Hanna RF, Brown MA, Pereira JM, Cunha R, et al. Cross-sectional Imaging of Extranodal Involvement in Abdominopelvic Lymphoproliferative Malignancies. RadioGraphics. 2007;27:1613–34.
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Dhull, V.S., Sharma, P., Singla, S. et al. Extensive Extranodal Involvement of Rare Sites in Non Hodgkin’s Lymphoma Detected on 18F- FDG PET-CT: A Case Report. Nucl Med Mol Imaging 47, 125–129 (2013). https://doi.org/10.1007/s13139-012-0183-3
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DOI: https://doi.org/10.1007/s13139-012-0183-3