Diffuse pulmonary uptake on FDG-PET with normal CT diagnosed as intravascular large B-cell lymphoma: a case report and a discussion of the causes of diffuse FDG uptake in the lungs

Cancer Imaging. 2012 Jan 23;12(1):7-12. doi: 10.1102/1470-7330.2012.0002.

Abstract

A 71-year-old woman was admitted to our hospital with asthenia, weight loss, fever, cognitive impairment and shortness of breath. Physical examination showed hemiparesis and cerebellar ataxia. There was no superficial lymphadenopathy. Blood tests showed raised levels of C-reactive protein and lactate dehydrogenase. Bone marrow aspiration and biopsy were negative. [18F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) showed intense uptake within a right apical nodule and intense and diffuse uptake of FDG in the lungs without corresponding structural CT abnormality. Lung biopsy showed intravascular large B-cell lymphoma (IVLBCL). FDG-PET findings in IVLBCL and causes of diffuse FDG lung uptake with and without CT abnormalities are discussed.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow / pathology
  • Brain / diagnostic imaging
  • Capillaries / diagnostic imaging*
  • Cognition Disorders / etiology
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • False Negative Reactions
  • Female
  • Fever / etiology
  • Fluorine Radioisotopes / pharmacokinetics*
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Humans
  • Lung / blood supply*
  • Lymphoma, Large B-Cell, Diffuse / complications
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging*
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Multimodal Imaging*
  • Paresis / etiology
  • Positron-Emission Tomography*
  • Prednisone / administration & dosage
  • Radiopharmaceuticals / pharmacokinetics*
  • Rituximab
  • Tissue Distribution
  • Tomography, X-Ray Computed
  • Vincristine / administration & dosage

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol