A 18F-FDG-positive, 67Ga-negative, and transferrin receptor expression-negative patient with diffuse large B-cell lymphoma

Abstract

We recently experienced a case with uveitis suffering from fever of unknown origin suspected of being caused by sarcoidosis. Chest computed tomography showed right supraclavicular, bilateral mediastinal, and right hilar lymphadenopathy, and intensive abnormal uptake of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) was observed on positron emission tomography with 18F-FDG (FDG-PET). On the other hand, 67Ga scintigraphy showed almost no abnormal findings. Histopathological examination revealed the lesion to be a diffuse large B-cell lymphoma (DLBCL), namely, an aggressive non-Hodgkin lymphoma from a right supraclavicular lymph node biopsy specimen. Additional immunohistochemical analysis showed the negative expression of transferrin receptor (TfR) on the formalin-fixed paraffin-embedded specimen. Although DLBCL is generally considered to be a 67Ga-avid tumor, it does not always have a large number of TfRs and that leads to a discrepancy between the 67Ga scintigraphy and FDG-PET findings. FDG-PET should be more appropriate for the initial staging of DLBCL than 67Ga scintigraphy, whereas 67Ga scintigraphy might be able to provide additional information including prognostic factors and to support strategies that target TfR for cancer therapy.

Fluorine-18 Fluorodeoxyglucose with Positron Emission Tomography Revealed Bone Marrow Involvement in Sarcoidosis Patients with Anaemia

“…As shown in figure 4 , there was a sustained increase in haemoglobin (14.2 g/dl) and a concomitant decrease in sACE (0.5 UNV). 18 F-FDG PET performed 6 months later showed a dramatic decrease in bone marrow glucose uptake as well as in other previous hypermetabolic sites ( fig. 2 a).…”

“…Clinical, laboratory and 18 F-FDG PET data were collected. The files of all sarcoidosis patients without anaemia (n = 7) who underwent 18 F-FDG PET imaging at the same period of time (between 2004 and 2007) were reviewed as a control group. Clinical, laboratory and 18 F-FDG PET features were compared between sarcoidosis patients with or without bone marrow involvement, although no statistical analysis was possible.…”

“…A low-dose helical CT scan was performed before PET acquisition. Acquisitions of PET images started 1 h after intravenous injection of 5 MBq/kg body mass of 18 F-FDG. The scan included the whole body from the skull to the upper part of the thighs.…”

“…The haemoglobin level was 10.6 g/dl, the mean corpuscular volume (MCV) was 80 m 3 , serum angiotensin converting enzyme (sACE) was 1.5 upper normal value (UNV), chest roentgenogram and pulmonary function tests were unchanged. 18 F-FDG PET was performed and showed multiple foci of increased uptake of FDG in bones, bone marrow, skin, lungs, mediastinum and spleen ( fig. 1 , 2 a).…”

“…Diabetes insipidus-related hypernatraemia and lymphocytic meningitis were evidenced suggesting neurosarcoidosis. 18 F-FDG PET was performed ( fig. 2 b) and revealed mediastinal, hepatic, hypothalamic, pituitary gland and axial skeleton hypermetabolism.…”