RESUMO
F-18-fluoro-deoxy-glucose positron emission tomography (PET) is a powerful tool for the imaging of aggressive B-cell lymphomas. In contrast, there is relatively little data on PET in follicular lymphoma grade 1 (FL-1) and grade 2 (FL-2). In this manuscript, we present our findings utilizing PET in treated FL-1 and FL-2. A retrospective review of patients who underwent PET examinations at our institution produced 95 PET examinations among 31 patients with FL-1 and FL-2. PET was obtained at initial staging, mid-induction and post-treatment. Results were compared with clinical follow-up. PET had high sensitivity (95%) and specificity (88%) for lesion detection in treated FL-1 and FL-2. Abnormal foci in FL-1 and FL-2 had similar intensities. Post-induction PET positive patients had shorter mean progression free survivals compared with PET negative patients (p-value < or =0.001), post-salvage PET positive trended toward shorter mean response duration compared with negative patients (p-value: 0.09). Our results indicate that PET is accurate in the diagnostic assessment of treated FL-1 and FL-2 and, post-treatment PET positive patients are likely to relapse prior to PET negative patients.
Assuntos
Fluordesoxiglucose F18 , Linfoma Folicular/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Medula Óssea , Intervalo Livre de Doença , Humanos , Linfoma Folicular/terapia , Recidiva Local de Neoplasia/diagnóstico , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Indução de Remissão , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Taxa de Sobrevida , Tomografia Computadorizada por Raios X , Resultado do TratamentoAssuntos
Doenças do Aparelho Lacrimal/diagnóstico , Sarcoidose/diagnóstico , Anti-Inflamatórios/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Hipercalcemia/etiologia , Aparelho Lacrimal/patologia , Doenças do Aparelho Lacrimal/complicações , Doenças do Aparelho Lacrimal/tratamento farmacológico , Doenças do Aparelho Lacrimal/fisiopatologia , Linfoma de Células B/complicações , Linfoma de Células B/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Prednisona/uso terapêutico , Sarcoidose/complicações , Sarcoidose/tratamento farmacológico , Sarcoidose/fisiopatologia , Resultado do TratamentoRESUMO
BACKGROUND: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is often associated with concurrent or subsequent development of T-cell/histiocyte-rich large B-cell lymphoma (THR-LBCL). Distinguishing the two is important because their therapies are different. Functional imaging with PET/CT is used to stage both Hodgkin and non-Hodgkin lymphomas. Aggressive lymphomas are usually more PET avid than the indolent subtypes. Therefore, it is possible that PET/CT may help distinguish NLPHL from THR-LBCL. PATIENTS AND METHODS: Herein, we retrospectively describe the clinical and PET/CT findings of 12 patients with NLPHL or THR-LBCL seen from 2004-2010. RESULTS AND CONCLUSIONS: Six patients each were identified and the average SUVmax was 6.9 (range, 5.7-7.3) in NLPHL and 16.6 (range, 4-29) in THR-LBCL (p = 0.055). Bone and extranodal involvement was found in one patient with NLPHL compared to four patients with THR-LBCL. This patient failed to respond to ABVD and was subsequently found to have THR-LBCL. We suggest that patients with NLPHL and THR-LBCL have different clinical and PET/CT characteristics. NLPHL patients had lower SUVmax on PET/CT compared to those with THR-LBCL. The presence of bone or extranodal involvement is more common in patients with THR-LBCL. Patients with NLPHL and an uncharacteristically higher SUVmax on PET/CT, or those with bone or extranodal involvement, should alert the clinician to consider the presence of THR-LBCL.