Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2001-7-2
pubmed:abstractText
We report on a patient with Hodgkin's disease who presented with hypodense splenic lesions and corresponding increased glucose metabolism in FDG-PET imaging, four months after completion of initial treatment, suggestive of early relapse. Serological testing for toxoplasma gondii, however, showed evidence of a recently reactivated or newly acquired infection. Three weeks after immediate antibiotic treatment with Daraprime and Sulfadiazin, the splenic lesions had completely resolved. Additionally, serological titers for toxoplasma gondii were normalized and whole body FDG-PET imaging showed no metabolic activity. Although the positive predictive value of PET imaging to indicate lymphoma is reported to be higher than CT, hypermetabolic lesions are not specific for malignant tissue. Whereas benign tumors typically show low glucose metabolism, activated granulocytes and macrophages may display significantly increased glucose consumption. In conclusion, our case report shows that although therapeutic decisions are often based on the results of imaging modalities, the taking of a detailed history and the acquisition of histological confirmation of the suspected lymphoma relapse are also advisable where possible. Cellular immunodeficiency can result in severe infections even in patients with intermediate stage Hodgkin's lymphoma in remission after combined modality treatment. Therefore, despite the high sensitivity of FDG-PET imaging for the detection of recurrent lymphoma, the differential diagnosis of infectious lesions should be kept in mind, in particular in immunocompromised patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
0923-7534
pubmed:author
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
719-22
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:11432634-Adult, pubmed-meshheading:11432634-Animals, pubmed-meshheading:11432634-Diagnosis, Differential, pubmed-meshheading:11432634-False Positive Reactions, pubmed-meshheading:11432634-Female, pubmed-meshheading:11432634-Fluorodeoxyglucose F18, pubmed-meshheading:11432634-Glucose, pubmed-meshheading:11432634-Hodgkin Disease, pubmed-meshheading:11432634-Humans, pubmed-meshheading:11432634-Immunocompromised Host, pubmed-meshheading:11432634-Neoplasm Recurrence, Local, pubmed-meshheading:11432634-Radiopharmaceuticals, pubmed-meshheading:11432634-Sensitivity and Specificity, pubmed-meshheading:11432634-Serologic Tests, pubmed-meshheading:11432634-Splenic Neoplasms, pubmed-meshheading:11432634-Tomography, Emission-Computed, pubmed-meshheading:11432634-Tomography, X-Ray Computed, pubmed-meshheading:11432634-Toxoplasma, pubmed-meshheading:11432634-Toxoplasmosis
pubmed:year
2001
pubmed:articleTitle
Pitfalls in imaging Hodgkin's disease with computed tomography and positron emission tomography using fluorine-18-fluorodeoxyglucose.
pubmed:affiliation
Department of Hematology and Oncology, Technische Universität München, Munich, Germany. Michael.Sandherr@lrz.tu-muenchen.de
pubmed:publicationType
Journal Article, Case Reports