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Kozuki R, Sugimoto T, Goto H, Miyamoto N, Hirakawa Y, Umeno A, Idei M, Tagawa S, Namba F, Tani R, Ohmori M, Hamanaka A, Adachi S, Tomita M. Optimal index for detecting splenic involvement on 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging in diffuse large B-cell lymphoma. Medicine (Baltimore) 2024; 103:e37290. [PMID: 38428864 PMCID: PMC10906632 DOI: 10.1097/md.0000000000037290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/26/2024] [Indexed: 03/03/2024] Open
Abstract
Accurate clinical staging is important in diffuse large B-cell lymphoma (DLBCL) to adapt to optimal therapy. Splenic involvement of DLBCL has been recently more detectable with the advancement of a diagnostic scan by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT). Our clinical question is whether splenic involvement was adequately diagnosed by FDG-PET/CT imaging. This retrospective study aimed to determine the optimal index for evaluating splenic involvement in patients with DLBCL. Patients with newly diagnosed DLBCL who were examined with FDG-PET/CT at diagnosis and the end of induction chemotherapy (EOI) was enrolled. The splenic involvement with the splenic FDG uptake value higher than that of the liver at diagnosis or with the decrease of splenic uptake at EOI by visual evaluation was evaluated as positive. The calculative evaluation of splenic involvement, based on the data of standardized uptake value (SUV) of the spleen, used maximum SUV (SUVmax), mean SUV (SUVmean), spleen total lesion glycolysis (spleen TLG), and spleen length. A change in each index following induction chemotherapy was expressed as an index. Receiver operating characteristic analysis was used to set the cutoff value for each index. This study included 52 patients. Spleen TLG (0.904) showed the best accuracy, followed by SUVmax (0.885) and SUVmean (0.885), among the 5 indexes for splenic involvement at diagnosis. Splenic involvement was predicted with a higher accuracy level (0.923) when selecting the cases with values higher than the cutoff level on both spleen TLG and SUVmax. The decision at EOI was more suitable by selecting both positive cases of ∆ TLG and ∆ SUVmax. Obtaining both the positive spleen TLG and SUVmax is recommended at diagnosis to predict splenic involvement. The assessment by ∆ spleen TLG and ∆ SUVmax seems to be optimal.
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Affiliation(s)
- Ryohei Kozuki
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Takeshi Sugimoto
- Department of Hematology and Oncology, Kita-Harima Medical Center, Hyogo, Japan
| | - Hideaki Goto
- Department of Hematology and Oncology, Kita-Harima Medical Center, Hyogo, Japan
- Department of Oncology and Hematology, Hyogo Prefectural HarimaHimeji General Medical Center, Himeji, Japan
| | - Naokazu Miyamoto
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Yuri Hirakawa
- Department of Hematology and Oncology, Kita-Harima Medical Center, Hyogo, Japan
| | - Akihiro Umeno
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Mari Idei
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Sumire Tagawa
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Fumiko Namba
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Ryuichiro Tani
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Mika Ohmori
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Akihiro Hamanaka
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Shuji Adachi
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
| | - Masaru Tomita
- Department of Diagnostic Radiology, Kita-Harima Medical Center, Hyogo, Japan
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Pallavi M, Murali A, Periakaruppan G, Easwaramoorthy V, Mohanarangam VSP. Correlation between Reference Tissue Normalized 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Standardized Uptake Value Max of Nodal and Extranodal Sites in Lymphomas: An Empirical Study. Indian J Nucl Med 2021; 36:371-376. [PMID: 35125754 PMCID: PMC8771065 DOI: 10.4103/ijnm.ijnm_74_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/10/2021] [Indexed: 11/08/2022] Open
Abstract
Context: Extranodal (EN) lymphomas involve sites other than lymph nodes (LNs), spleen, thymus, and the pharyngeal lymphatic ring. The highest standardized uptake value (SUV) max of the LN can aid in the diagnosis of EN site lymphomatous infiltrations over inflammation or infection especially when there are no contrast-enhanced computed tomography (CT) changes. Aims: The purpose of this study was to find the significance of correlation between absolute SUVmax and mediastinal blood pool (mbSUVmax) and liver (lvSUVmax) normalized SUVmax of EN sites and the most fluorodeoxyglucose (FDG) avid LN in patients with primary and secondary EN involvement in Non-Hodgkin's and Hodgkin's Lymphoma. Settings and Design: This was a retrospective study of 70 patients with histopathologically proven lymphoma in whom 18F-FDG positron emission tomography CT was performed for pretherapy staging. Materials and Methods: Images were used to detect EN sites of disease and SUVmax of mediastinal blood pool, liver, highest SUVmax LN, and highest SUVmax EN site were calculated. Statistical Analysis Used: Karl Pearson's coefficient of correlation (r) was used to correlate the highest SUV max of LN and EN site and corresponding highest blood pool corrected and liver corrected SUV max. In view of small sample size, t-test for paired samples at 5% and 10% significance was conducted to validate the findings. Two-tailed t-test for independent samples was also used to compare means of SUVmax values between data grouped according to gender and lymphoma subtype (Non-Hodgkin lymphoma and Hodgkin lymphoma). Results: r = 0.54 for the highest LN SUVmax-highest EN SUVmax values and on further validation by one- and two-tailed paired t-test at significance levels of 5% and 10%, P = 0.00052 and 0.00103 respectively which denoted significant positive and moderate correlation. r = 0.59 for highest LN lvSUVmax-highest EN vSUVmax and P = 0.00032 and 0.00065 showing positive and moderate correlation. r = 0 0.82 for highest LN mbSUVmax-highest EN mbSUVmax values and P = 0.00034 and 0.00068 revealing positive and strong correlation. Conclusion: Significant positive and strong correlation exists between nodal and EN mbsUVmax. This is stronger than the correlation between nodal and EN absolute SUVmax and lvSUVmax. Since normalization of lesion SUVmax to reference tissues reduces the variability of SUV, this can be a useful adjunct to determine whether high SUVmax of the EN site is due to lymphomatous infiltration.
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Affiliation(s)
- Mannam Pallavi
- Department of Nuclear Medicine and PETCT, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Arunan Murali
- Department of Nuclear Medicine and PETCT, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Gokulakrishnan Periakaruppan
- Department of Nuclear Medicine and PETCT, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Venkatachalapathy Easwaramoorthy
- Department of Radiology and Imaging Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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Kurch L, Kluge R, Sabri O, Fischer L, Wendt S, Graf Einsiedel H, Starke S, Kühl JS, Christiansen H, Hirsch FW, Sorge I, Roth C. Whole-body [ 18F]-FDG-PET/MRI for staging of pediatric non-Hodgkin lymphoma: first results from a single-center evaluation. EJNMMI Res 2021; 11:62. [PMID: 34216300 PMCID: PMC8254839 DOI: 10.1186/s13550-021-00804-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Abstract
Aim In 2015, the revised International Pediatric Non-Hodgkin Lymphoma Staging System was published. It mentions [18F]-FDG-PET/MRI as the latest method to perform whole-body imaging. However, supporting data are pending. Our aim was to investigate the performance of whole-body [18F]-FDG-PET/MRI in pediatric non-Hodgkin lymphoma patients by using a limited number of MRI sequences. Materials and methods Ten pediatric patients with histologically proven non-Hodgkin lymphoma underwent whole-body [18F]-FDG-PET/MRI at staging. The retrospective analysis included three steps: First, [18F]-FDG-PET and MR scans were evaluated separately by a nuclear medicine physician and a pediatric radiologist. Nineteen nodal and two extranodal regions as well as six organs were checked for involvement. Second, discrepant findings were reviewed together in order to reach consensus. Third, [18F]-FDG-PET/MRI findings were correlated with the results of other clinical investigations. Results Of the 190 lymph node regions evaluated, four were rated controversial. Consensus was reached by considering metabolic, functional and morphologic information combined. Concordantly, [18F]-FDG-PET and MRI detected Waldeyer’s ring involvement in two patients whose Waldeyer’s ring was negative on clinical assessment. In four patients MRI showed pleural effusion. However, in only two of them an increased glucose metabolism as a reliable sign of pleural involvement was detectable. In six patients [18F]-FDG-PET and MRI detected skeletal lesions although bone marrow biopsy was positive in only one of them. Conclusion Despite the small number of cases evaluated, whole-body [18F]-FDG-PET turned out to be a valuable tool for staging of pediatric non-Hodgkin lymphoma.
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Affiliation(s)
- L Kurch
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany.
| | - R Kluge
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - L Fischer
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - S Wendt
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - H Graf Einsiedel
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - S Starke
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - J-S Kühl
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - H Christiansen
- Department of Pediatric Oncology, Hematology and Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - F W Hirsch
- Institute of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
| | - I Sorge
- Institute of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
| | - C Roth
- Institute of Pediatric Radiology, University Hospital Leipzig, Leipzig, Germany
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Singh V, Kumar A, Singh P, Ora M, Gambhir S. Extensive Extranodal Involvement in a case of Non-Hodgkin's Lymphoma with sparing of lymph nodes and lymphatic organs. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2021; 9:39-44. [PMID: 33392348 PMCID: PMC7701225 DOI: 10.22038/aojnmb.2020.47774.1324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a group of malignant lymphoproliferative disorders arising predominantly in the lymph nodes with various clinical and histological characteristics. At least 25% of NHL originates from tissues other than lymph nodes and sometimes even from sites that do not contain lymphoid tissue. These are referred to as primary extranodal lymphomas (pENLs). pENL is a universal diagnostic challenge to the clinicians and pathologists due to their varied clinical presentations, morphological mimicry, and molecular alterations. The GIT is the most common site of pENL followed by nasopharynx/oropharynx, testis, uterus/ovary, thyroid, and central nervous system. Long bones (tibia), maxillary sinus, skin, and paraspinal soft tissues are the other rare anatomic sites of pENL. We reported a case of a 60-year-old female presented with pain and mass in the pelvis region. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and fused PET/CT was done, which revealed extensive extranodal involvement of the lung, bilateral kidneys, uterus, ovaries, bones, and muscles with no involvement of lymph nodes or lymphomatous organs. Extensive extranodal involvement with sparing of lymphomatous organ has not been reported earlier.
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Affiliation(s)
| | - Akshay Kumar
- Corresponding author: Akshay Kumar. Department of nuclear medicine, SGPGIMS, Lucknow (Uttar Pradesh), India- 226014. Tel: +919968947884
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Wyrzykowski M, Siminiak N, Kaźmierczak M, Ruchała M, Czepczyński R. Impact of the Q.Clear reconstruction algorithm on the interpretation of PET/CT images in patients with lymphoma. EJNMMI Res 2020; 10:99. [PMID: 32845406 PMCID: PMC7450027 DOI: 10.1186/s13550-020-00690-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
Background Q.Clear is a new Bayesian penalized-likelihood PET reconstruction algorithm. It has been documented that Q.Clear increases the SUVmax values of different malignant lesions. Purpose SUVmax values are crucial for the interpretation of PET/CT images in patients with lymphoma, particularly when the early and final responses to treatment are evaluated. The aim of the study was to systematically analyse the impact of the use of Q.Clear on the interpretation of PET/CT in patients with lymphoma. Methods A total of 280 18F-FDG PET/CT scans in patients with lymphoma were performed for staging (sPET), for early treatment response (iPET), after the end of treatment (ePET) and when a relapse of lymphoma was suspected (rPET). Scans were separately reconstructed with two algorithms, Q.Clear and OSEM, and further compared. Results The stage of lymphoma was concordantly diagnosed in 69/70 patients with both algorithms on sPET. Discordant assessment of the Deauville score (p < 0.001) was found in 11 cases (15.7%) of 70 iPET scans and in 11 cases of 70 ePET scans. An upgrade from a negative to a positive scan by Q.Clear occurred in 3 cases (4.3%) of iPET scans and 7 cases (10.0%) of ePET scans. The results of all 70 rPET scans were concordant. The SUVmax values of the target lymphoma lesions measured with Q.Clear were higher than those measured with OSEM in 88.8% of scans. Conclusion Although the Q.Clear algorithm may alter the interpretations of PET/CT in only a small proportion of patients, we recommend using standard OSEM reconstruction for the assessment of treatment response.
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Affiliation(s)
| | - Natalia Siminiak
- Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Kaźmierczak
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznań, Poland
| | - Marek Ruchała
- Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznań, Poland
| | - Rafał Czepczyński
- Department of Nuclear Medicine, Affidea Poznań, Poznań, Poland.,Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznań, Poland
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Spijkers S, Littooij AS, Humphries PD, Lam MGEH, Nievelstein RAJ. Imaging features of extranodal involvement in paediatric Hodgkin lymphoma. Pediatr Radiol 2019; 49:266-276. [PMID: 30515533 PMCID: PMC6334729 DOI: 10.1007/s00247-018-4280-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/06/2018] [Accepted: 10/05/2018] [Indexed: 12/15/2022]
Abstract
Detecting extranodal disease in paediatric Hodgkin lymphoma is of great importance for both treatment and prognosis. Different imaging techniques can be used to identify these extranodal sites. This pictorial essay provides an overview of imaging features of extranodal disease manifestation in paediatric Hodgkin lymphoma.
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Affiliation(s)
- Suzanne Spijkers
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands.
| | - Annemieke S. Littooij
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Paul D. Humphries
- Department of Specialist Radiology, University College London Hospital, London, UK ,Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Marnix G. E. H. Lam
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Rutger A. J. Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Oral A, Yazıcı B, Ömür Ö. 18F-FDG PET/CT Findings of Non-Hodgkin Lymphoma Involving the Whole Genitourinary System. Mol Imaging Radionucl Ther 2018; 27:138-140. [PMID: 30317852 PMCID: PMC6191729 DOI: 10.4274/mirt.63497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A sixty-two-year-old male patient underwent orchiectomy and was diagnosed with diffuse large B-cell lymphoma in the testicle and spermatic cord. 18F-FDG positron emission tomography/computed tomography (PET/CT) scanning was performed for initial staging. 18F-FDG PET/CT scan revealed multiple hyper-metabolic lymphadenopathies, lung lesions and mass lesions in the adrenal glands and kidneys. In addition, diffuse increased 18F-FDG uptake suggesting lymphomatous infiltration on the right testicle, prostate and left testicular veins were detected. The genitourinary system involvement is extremely rare in extra-nodal lymphomas and to the best of our knowledge this is the first case in the literature having 18F-FDG accumulating lesions in all genitourinary system structures.
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Affiliation(s)
- Aylin Oral
- Ege University Faculty of Medicine, Department of Nuclear Medicine, İzmir, Turkey
| | - Bülent Yazıcı
- Ege University Faculty of Medicine, Department of Nuclear Medicine, İzmir, Turkey
| | - Özgür Ömür
- Ege University Faculty of Medicine, Department of Nuclear Medicine, İzmir, Turkey
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Rigacci L, Kovalchuk S, Berti V, Puccini B, Mannelli L, Benelli G, Dini C, Pupi A, Bosi A. The use of Deauville 5-point score could reduce the risk of false-positive fluorodeoxyglucose-positron emission tomography in the posttherapy evaluation of patients with primary bone lymphomas. World J Nucl Med 2018; 17:157-165. [PMID: 30034279 PMCID: PMC6034538 DOI: 10.4103/wjnm.wjnm_42_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primary bone lymphoma (PBL) is a rare disease. Little is reported about response evaluation procedures in these patients. Our aim was to evaluate response to therapy according to fluorodeoxyglucose-positron emission tomography (FDG-PET) results, and in particular to test the Deauville 5-point scale as compared to the visual evaluation of FDG-PET scans in PBL. In this single-center study, we diagnosed 31 consecutive patients with PBL, of which 24 were evaluated with end-of-treatment FDG-PET. Patients' ages ranged from 19 to 82 years. Six patients were treated with chemotherapy, 24 with chemotherapy and radiotherapy, and one patient with radiotherapy alone. Six patients were affected by a pathological fracture. Four patients died within the range of 3 to 36 months after diagnosis. The average follow-up of the remaining patients was 70 (24–173) months. Overall survival was 87% at 5 years. The only positive prognostic factor was complete remission after chemotherapy. According to visual criteria, end-of-treatment FDG-PET was evaluated in 24 patients and it was positive in 11 (46%) and negative in 13 patients. We organized a retrospective central-blinded revision of end-of-therapy FDG-PET scans using the 5-point Deauville Score (DS). We reviewed 17 out of 24 patients and obtained the following results: at the end of therapy, 12 patients with DS score 2, three patients with DS score 3, one patient with DS score 4, and none with DS score 5. Considering that all the 24 patients achieved complete remission after treatment, visual interpretation produced 11/24 false-positive results, and DS interpretation produced 1/17 false-positive results, thus significantly reducing the number of false positives. In PBL, the final evaluation at the end of therapy with FDG-PET should be evaluated using Deauville 5-point scale in order to significantly reduce the risk of false-positive scans.
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Affiliation(s)
- Luigi Rigacci
- Department of Hematology, University of Florence, Florence, Italy
| | - Sofia Kovalchuk
- Department of Hematology, University of Florence, Florence, Italy
| | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences, Nuclear Medicine Unit, University of Florence, Florence, Italy
| | | | - Lara Mannelli
- Department of Hematology, University of Florence, Florence, Italy
| | - Gemma Benelli
- Department of Hematology, University of Florence, Florence, Italy
| | - Catia Dini
- Department of Radiology, AOU Careggi, Florence, Italy
| | - Alberto Pupi
- Department of Biomedical, Experimental and Clinical Sciences, Nuclear Medicine Unit, University of Florence, Florence, Italy
| | - Alberto Bosi
- Department of Hematology, University of Florence, Florence, Italy
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Karunanithi S, Kumar G, Sharma P, Bal C, Kumar R. Potential role of (18)F-2-fluoro-2-deoxy-glucose positron emission tomography/computed tomography imaging in patients presenting with generalized lymphadenopathy. Indian J Nucl Med 2015; 30:31-8. [PMID: 25589803 PMCID: PMC4290063 DOI: 10.4103/0972-3919.147532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Generalized lymphadenopathy is a common and often vexing clinical problem caused by various inflammatory, infective and malignant diseases. We aimed to review briefly and highlight the potential role of 18F-2-fluoro-2-deoxy-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in such patients. 18F-FDG PET/CT can play an important role in the management of generalized lymphadenopathy. It can help in making an etiological diagnosis; can detect extranodal sites of involvement and employed for monitoring response to therapy.
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Affiliation(s)
- Sellam Karunanithi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ganesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Punit Sharma
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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Ma J, Wang Y, Zhao H, Liu S, Li Q, Lin L, Yue Y, Wang X, Zhao Z, Yu Y, Zhang Y. Clinical characteristics of 26 patients with primary extranodal Hodgkin lymphoma. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:5045-50. [PMID: 25197377 PMCID: PMC4152067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 07/12/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Most Hodgkin lymphoma (HL) patients present with disease in nodal regions. However, in a small subset, disease develops extranodal sites primarily, such as lung and liver. This study aims to identify the characteristics and outcomes of patients with primary extranodal HL. METHODS A retrospective analysis of patients with HL from 1998 to 2012 was enrolled. We selected 26 HL patients with primary extranodal involvement from 251 previously untreated HL patients. All data analyses were performed with SPSS software version 17.0 and GraphPad Prism 5. RESULTS We identified 26 patients with primary extranodal HL. Results in the series of young patients, male predominated. Pathologically, the major pathologic types were nodular sclerosis classical HL (NSCHL, 46.2%) and mixed cellularity classical HL (MCCHL, 38.5%). Thirteen patients had early stage (I or II stage). The most commonly primarily extranodal sites were the lung and the stomach and intestine, followed by the liver and bones. Fifteen of 26 received chemotherapy alone and 11 received combination therapy. Finally, primary extranodal HLs in our study have a favorable survival. Furthermore, there was no significant association between the international prognostic score (IPS) and survival in patients with extranodal HL. CONCLUSION Our retrospective data in part reflect clinical characteristics of primary extranodal HL in China, and form the basis for further concerning researches.
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Affiliation(s)
- Jing Ma
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yafei Wang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Haifeng Zhao
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Su Liu
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Qian Li
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Li Lin
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yuanfang Yue
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Xiaofang Wang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Zhigang Zhao
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yong Yu
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
| | - Yizhuo Zhang
- Department of Hematology and Blood and Marrow Transplantation, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy Huan-Hu-Xi Road, Ti-Yuan-Bei, He Xi District, Tianjin 300060, China
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