open access

Vol 10, No 1 (2007)
Submitted: 2012-01-23
Published online: 2007-02-15
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FDG-PET detection of primary bone marrow large B-cell lymphoma in a patient with hairy cell leukemia

Rossella Paolini, Enzo Bianchini, Emma D' Andrea, Adil Al-Nahhas, Elena Banti, Pier Carlo Muzzio, Domenico Rubello
Nucl. Med. Rev 2007;10(1):23-25.

open access

Vol 10, No 1 (2007)
Submitted: 2012-01-23
Published online: 2007-02-15

Abstract

We describe a case of hairy cell leukaemia (HCL) coexistent with non-Hodgkin's lymphoma (NHD). This combination is reported to be extremely rare with no clear demonstration of the clonal relationship between the two conditions. After a previous failure of purine analogue therapy, our patient was successfully treated with rituximab resulting in normalisation of blood cell count cessation of blood transfusion and negative iliac crest biopsy. Unfortunately, the patient developed intense and persistent bone pain during the 1st line treatment for HCL. Skeletal X-rays, neck-thorax-abdomen CT scan and repeated bone MRI were unremarkable and bone scintigraphy showed non-specific changes. Laboratory examinations were normal. To better evaluate bone scintigraphy results, we finally performed FDG-PET/CT, which showed multiple foci of intense abnormal radiotracer uptake involving the bone marrow. An FDG-PET/CT guided bone marrow biopsy showed primary bone marrow diffuse large B-cell lymphoma (LBCL). Despite 2nd and 3rd line treatment, the patient died shortly after for central nervous system involvement by NHD.
The role of FDG-PET/CT in identifying bone and bone marrow localization of NHD is reviewed and an earlier use is suggested in poorly understood bone pain.

Abstract

We describe a case of hairy cell leukaemia (HCL) coexistent with non-Hodgkin's lymphoma (NHD). This combination is reported to be extremely rare with no clear demonstration of the clonal relationship between the two conditions. After a previous failure of purine analogue therapy, our patient was successfully treated with rituximab resulting in normalisation of blood cell count cessation of blood transfusion and negative iliac crest biopsy. Unfortunately, the patient developed intense and persistent bone pain during the 1st line treatment for HCL. Skeletal X-rays, neck-thorax-abdomen CT scan and repeated bone MRI were unremarkable and bone scintigraphy showed non-specific changes. Laboratory examinations were normal. To better evaluate bone scintigraphy results, we finally performed FDG-PET/CT, which showed multiple foci of intense abnormal radiotracer uptake involving the bone marrow. An FDG-PET/CT guided bone marrow biopsy showed primary bone marrow diffuse large B-cell lymphoma (LBCL). Despite 2nd and 3rd line treatment, the patient died shortly after for central nervous system involvement by NHD.
The role of FDG-PET/CT in identifying bone and bone marrow localization of NHD is reviewed and an earlier use is suggested in poorly understood bone pain.
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Keywords

FDG-PET/CT imaging; lymphoma; bone marrow involvement; HCL

About this article
Title

FDG-PET detection of primary bone marrow large B-cell lymphoma in a patient with hairy cell leukemia

Journal

Nuclear Medicine Review

Issue

Vol 10, No 1 (2007)

Pages

23-25

Published online

2007-02-15

Page views

599

Article views/downloads

1348

Bibliographic record

Nucl. Med. Rev 2007;10(1):23-25.

Keywords

FDG-PET/CT imaging
lymphoma
bone marrow involvement
HCL

Authors

Rossella Paolini
Enzo Bianchini
Emma D' Andrea
Adil Al-Nahhas
Elena Banti
Pier Carlo Muzzio
Domenico Rubello

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