18F-FDG PET/CT-Guided Diagnosis and Evaluation of Treatment Response to Cyclosporine A in Maldistributed Subcutaneous Panniculitis-like T-Cell Lymphoma Without Typical Skin Rash

Clin Nucl Med. 2020 Feb;45(2):e69-e71. doi: 10.1097/RLU.0000000000002863.

Abstract

A 30-year-old woman presented with persistent fever and elevated lactate dehydrogenase levels without skin rash. F-FDG PET/CT revealed FDG uptake in subcutaneous tissues in the forearm, buttocks, and lower limbs, whereas the trunk was unaffected. She was diagnosed with subcutaneous panniculitis-like T-cell lymphoma based on a PET/CT-guided subcutaneous tissue biopsy from the thigh. Although conventional cytotoxic agent-based chemotherapies failed to achieve disease remission, subsequent cyclosporine A treatment promptly resolved the fever and laboratory abnormalities. Remarkably, abnormal FDG uptake disappeared entirely on follow-up PET/CT, demonstrating its utility in the evaluations of responses to emerging cyclosporine A-based treatments in subcutaneous panniculitis-like T-cell lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cyclosporine / pharmacology*
  • Cyclosporine / therapeutic use
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymphoma, T-Cell / diagnostic imaging*
  • Lymphoma, T-Cell / drug therapy*
  • Lymphoma, T-Cell / pathology
  • Panniculitis / diagnostic imaging*
  • Panniculitis / drug therapy*
  • Panniculitis / pathology
  • Positron Emission Tomography Computed Tomography*
  • Treatment Outcome

Substances

  • Fluorodeoxyglucose F18
  • Cyclosporine

Supplementary concepts

  • Subcutaneous panniculitis-like T-cell lymphoma