A 50-year-old man with angioimmunoblastic T-cell lymphoma in complete response to treatment presented new hypermetabolic brain lesions on 18F-FDG PET/CT suggestive of malignancy. These findings were correlated by MRI that showed cortical-subcortical peripheral lesions typical of acute ischemic infarction. A restaging 18F-FDG PET/CT showed that hypermetabolic lesions were replaced by ametabolic areas, supporting chronic infarction. Early ischemia presents transitory FDG increase. Brain lymphomas are highly FDG avid and difficult to differentiate from acute cerebral infarction. In view of the discordance of abnormal areas of intracranial uptake on PET FDG, MRI confirmation is required to avoid misinterpretation.
Burkitt lymphoma (BL) is a poorly differentiated non-Hodgkin B-cell lymphoma, more frequent in children than in adults. The extranodal debut of the disease is rare. We report a 43-year-old male patient with history of dyspnea. Burkitt lymphoma diagnosis was reached after biopsy of a pleural lesion. An initial staging F-FDG-PET/CT revealed large high-uptake lymphatic clusters in mediastinum, lung hilum, and extranodal involvement in pleura, pericardium, periphery of liver and spleen, all the omentum and peritoneum down to the pelvic floor, and bone marrow infiltration.
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