Unusual presentation of sarcoid-like reaction on bone marrow level associated with mediastinal lymphadenopathy on (18)F-FDG-PET/CT resembling an early recurrence of Hodgkin's Lymphoma

Rev Esp Med Nucl Imagen Mol. 2012 Jul-Aug;31(4):207-9. doi: 10.1016/j.remn.2012.03.002. Epub 2012 Apr 26.

Abstract

(18)F-FDG-PET/CT is widely employed to evaluate lymphoma patients. False positive results are quite frequent, generally due to active phase of inflammation. We describe an unusual PET/CT presentation of a sarcoid-like reaction (SLR) in a patient monitored for Hodgkin Lymphoma characterized by an intense uptake in lymph nodes and multiple bone foci in a PET/CT study. The final diagnosis was obtained by biopsy. This study draws attention to the fact that multifocal bone marrow uptakes due to a sarcoideal reaction may be a possible cause of false positive results in (18)F-FDG-PET/CT studies in oncology patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / administration & dosage
  • Bone Diseases / diagnostic imaging*
  • Bone Diseases / pathology
  • Bone Marrow / diagnostic imaging*
  • Bone Marrow / pathology
  • Combined Modality Therapy
  • Dacarbazine / administration & dosage
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Diagnosis, Differential
  • Doxorubicin / administration & dosage
  • False Positive Reactions
  • Female
  • Fluorine Radioisotopes*
  • Fluorodeoxyglucose F18*
  • Gemcitabine
  • Granuloma / diagnostic imaging*
  • Granuloma / pathology
  • Hodgkin Disease / diagnostic imaging*
  • Hodgkin Disease / drug therapy
  • Hodgkin Disease / radiotherapy
  • Hodgkin Disease / surgery
  • Humans
  • Ifosfamide / administration & dosage
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Mediastinum / diagnostic imaging*
  • Mediastinum / pathology
  • Multimodal Imaging*
  • Peripheral Blood Stem Cell Transplantation
  • Positron-Emission Tomography*
  • Prednisone / administration & dosage
  • Radiopharmaceuticals*
  • Recurrence
  • Remission Induction
  • Sarcoidosis / diagnosis
  • Tomography, X-Ray Computed*
  • Transplantation, Autologous
  • Vinblastine / administration & dosage
  • Vinblastine / analogs & derivatives
  • Vinorelbine

Substances

  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Deoxycytidine
  • Fluorodeoxyglucose F18
  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin
  • Vinorelbine
  • Ifosfamide
  • Prednisone
  • Gemcitabine