FDG PET/CT Findings of the Recurrent Posttransplantation Lymphoproliferative Disorder in a Pediatric Liver Transplant Recipient With Right Leg Pain as the Only Complaint

A 24-year-old man with a history of hemophagocytic lymphohistiocytosis (HLH) presented with swelling of the left foot and skin ulcer. The patient received bone marrow transplantation for HLH 3 years ago for his HLH. Biopsy of left foot skin demonstrated primary cutaneous natural killer/T-cell lymphoma: a posttransplant lymphoproliferative disorder. FDG PET/CT images demonstrated multiple foci of abnormal accumulation in the body, especially in the skin. Follow-up PET/CT after chemotherapy demonstrated that most abnormal activities disappeared except for the lesion in the left foot.

mentioning

confidence: 99%

“…6 Accurate staging is very important for PTLD. FDG PET/CT has been used in the diagnosis of PTLD [10][11][12][13][14] and in therapy response evaluation. 15 However, experience of FDG PET/CT is mainly limited to PTLD of B-cell origin.…”

mentioning

confidence: 99%

Primary Cutaneous Natural Killer/T-Cell Lymphoma

Kan

Wang

et al. 2021

“…FDG PET/CT was performed for staging. 1,2 The MIP (A) image demonstrated foci of increased FDG activity in the neck, liver, axillae, mediastinum, stomach, small bowel, and inguinal regions, consistent with known posttransplant lymphoproliferative disorder. In addition, on the sagittal view of the head (B), there was a focal activity (arrow), which was in the midline of the submental region (arrows) on the axial images (C: PET, D: fusion, E: CT) without corresponding anatomical abnormality, which was thought to be a submental lymph node activity.…”

mentioning

confidence: 80%

“…The liver biopsy confirmed posttransplant lymphoproliferative disorder. FDG PET/CT was performed for staging 1,2 . The MIP ( A ) image demonstrated foci of increased FDG activity in the neck, liver, axillae, mediastinum, stomach, small bowel, and inguinal regions, consistent with known posttransplant lymphoproliferative disorder.…”

mentioning

confidence: 99%

Increased Genioglossus Muscle FDG Activity Due to Using Pacifier

Tong

Zhuang

2022

Self Cite

An 18-month-old girl with history of liver transplant underwent FDG PET/CT to evaluate posttransplant lymphoproliferative disorder. In addition to multistation hypermetabolic lymphadenopathy and abnormal activity in the liver, stomach, and small bowel, in keeping with known posttransplant lymphoproliferative disorder, the images also showed focal activity in the submental region. This submental activity persisted on 2 separate follow-up FDG PET/CT studies, even though other foci of abnormal activity resolved after chemotherapy. Records revealed that the patient was sucking on a pacifier prior to all 3 FDG PET/CT studies, and the submental uptake corresponded with genioglossus muscle activity.

“…Imaging diagnostic methods are important in the diagnosis of central nervous system PTLD. 4 18 F-FDG PET/CT has been reported in the diagnosis, [5][6][7] follow-up, 8,9 and therapy response of PTLD. 7,[10][11][12] The present case emphasizes the value of 18 F-FDG PET/CT in monitoring the relapse of central nervous system PTLD.…”

mentioning

confidence: 99%

Solitary Central Nervous System Relapse of Posttransplant Lymphoproliferative Disorder on 18F-FDG PET/CT

Feng

Yang²,

Lu³

et al. 2022

A 41-year-old woman received stem cell transplant due to acute myeloid leukemia. Six months after the stem cell transplant, the patient experienced monomorphic PTLD (posttransplant lymphoproliferative disorder) and underwent chemotherapy. Postchemotherapy PET/CT did not show any abnormal 18 F-FDG accumulation in the scanned body, including brain. Four months later, she presented with nausea and vomiting. Brain MRI showed a lesion in the right temporal lobe. In addition to the abnormal 18 F-FDG accumulation in the brain, no other abnormal foci were noted in the torso PET/CT. Biopsy pathology confirmed the diagnosis of monomorphic PTLD.