File:Non-Hodgkin lymphoma involving seminal vesicles with development of interstitial pneumonitis during Rituximab therapy (Radiopaedia 32703-33752 ax CT Fus PET 47).jpg

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Summary:

Description
  • Radiopaedia case ID: 32703
  • Image ID: 9628922
  • Image stack position: 47/80
  • Plane projection: ax CT Fus PET
  • Study findings: Interim PET/CT (iPET) with low dose CT shows complete regression of hyper metabolic activity except in a few mediastinal lymph nodes, the activity of which has decreased, equaling liver uptake (Deauville scale 3). There is no structural progression on CT, but significant size reduction in most lesions. There is interval development of a hyper metabolic lesion in the perihilar region of the upper lobe of the left lung. CT part of the study depicts ground glass opacities without nodules. Diffuse bone marrow uptake is also noted, consistent with bone marrow drug effects. Conclusion Overall appearances compatible with complete (metabolic) response. Ground glass opacities in left upper lobe, compatible with pulmonary infection.
  • Modality: Nuclear medicine
  • System: Haematology
  • Findings: Enlarged and vividly FDG-enhancing seminal vesicles and appendix. FDG-avid infra- and supradiaphragmal lymphadenopathy is also noted, as well as predominantly nodular pulmonary involvement. Bilateral mild pleural effusion. No evidence of hepatic, splenic or bone marrow involvement. Incidental note is made of a gallstone in infundibulum, duodenal diverticulum, simple hepatic and renal cysts, a sub-cm lesion in the left hepatic lobe, mostly resembling hemangioma, and an umbilical hernia. Conclusion The overall imaging appearances with hyper metabolic involvement of nodal and extra nodal sites and the homogenously contrast-enhancing, but neither invasive nor vascular lesions are highly suggestive of malignant lymphoma.
Date Published: 19th Dec 2014
Source https://radiopaedia.org/cases/non-hodgkin-lymphoma-involving-seminal-vesicles-with-development-of-interstitial-pneumonitis-during-rituximab-therapy-1
Author René Pfleger
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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