FDG PET in Primary Effusion Lymphoma (PEL) of the Pericardium

Bhargava, Peeyush; Glass, Elizabeth; Jw, Brown; Eapen, Elizabeth; Ames, Elizabeth

doi:10.1097/01.rlu.0000191351.69681.32

Cited by 13 publications

(4 citation statements)

References 8 publications

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“…9 Limited information is available describing FDG-PET imaging in PCL. 15,20,21 Case reports suggest that PCL is an FGD avid lesion relative to surrounding myocardial, making PET a potentially useful imaging modality to monitor treatment response. Due to the lack of consensus regarding optimal imaging, our approach was initially to characterize and follow our patient with several imaging modalities to evaluate the utility of each in monitoring treatment response.…”

Section: Utility Of Multimodality Imaging In Diagnosis and Managementmentioning

confidence: 99%

Primary cardiac lymphoma: Utility of multimodality imaging in diagnosis and management

Mato

Morgans

Roullet

et al. 2007

Cancer Biology & Therapy

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Primary cardiac lymphoma (PCL) is an extremely rare disease defined as a lymphoma strictly confined to the heart or pericardium without dissemination. We present the case of an 82 yr old male with newly diagnosed PCL and two years of subsequent follow up. This report highlights the utility of a multimodality imaging approach in the diagnosis and management of PCL.An 82-year-old man with chronic atrial fibrillation presented in September 2005 with weight loss, night sweats, dyspnea, and chest pain. Transthoracic echocardiography was diagnostic of cardiac tamponade. A pericardial window was emergently placed and hemorrhagic pericardial fluid evacuated. A postoperative transthoracic echocardiogram revealed a 3.5 x 3 x 2.5 cm mass in the right atrium appearing to originate from the coronary sinus. Twelve days later, the patient underwent surgical resection of this mass (Fig. 1). Routine histopathology revealed a dense infiltrate of large malignant lymphoid cells with a brisk mitotic rate ( Fig. 2A). Immunohistochemistry showed co-expression by tumor cells of CD20 (Fig. 2B), CD79a, and BCL2 ( Fig. 2C) with weak BCL6 expression; CD5 and CD10 were not expressed. Ki-67 staining demonstrated a proliferative rate of 50% (Fig. 2D). Flow cytometric analysis of a cell suspension prepared from fresh tissue revealed a clonal population of kappa light chain restricted, large B-cells that expressed CD20 without co-expression of CD19, CD5, CD10, CD11c or CD23. These morphologic and immunophenotypic features were consistent with diffuse large B-cell lymphoma, probably of non-germinal center histogenic origin. 1,2 CT scans with IV contrast of the chest, abdomen and pelvis performed 3 days after surgery showed no pathologically enlarged lymph nodes or other evidence of lymphoma; an intracardiac mass was not identified. A combined CT / FDG-PET scan performed 10 days post-op revealed a large markedly hypermetabolic intra-atrial mass in the mid lower chest just above the level of the diaphragm without evidence of extra-cardiac involvement by lymphoma (Fig. 3). MRI examination of the heart performed 29 days post-op revealed a soft tissue mass located in the interatrial and basal interventricular septum measuring 5.6 x 3.6 x 3.6 cm with infiltration into the right atrial wall, right ventricular myocardium and basal left ventricle (Fig. 4). Laboratory data at presentation were remarkable for anemia and a mildly increased serum LDH (638 U/L; normal ≤618 U/L). The patient was diagnosed with stage IE primary cardiac lymphoma (PCL), diffuse large B-cell type (DLBCL).The patient received his first cycle of R-CHOP chemotherapy (Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) 29 days post-op. 3 Due to the patient's age and performance status, a decision was made to administer R-CHOP using a modified schedule as follows: Day 1-Rituximab 375mg/m 2 mg, doxorubicin 25 mg/m 2 , cyclophosphamide 375mg/m 2 mg, vincristine 1 mg and prednisone 50 mg daily for five days; Day 14-doxorubicin 25 mg/m 2 , cyclophosphamide 375 mg/m ...

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Section: Utility Of Multimodality Imaging In Diagnosis and Managementmentioning

confidence: 99%

Primary cardiac lymphoma: Utility of multimodality imaging in diagnosis and management

Mato

Morgans

Roullet

et al. 2007

Cancer Biology & Therapy

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“…8 In this case, with F-18 FDG-PET, the tumor was found to be located only in the heart and its periphery without pleural and lymph node involvement. Therefore, it was primary cardiac lymphoma by definition.…”

Section: Figurementioning

confidence: 93%

Primary Cardiac Lymphoma Evaluated With Integration of PET/CT and Contrast-Enhanced CT

Huang²,

Sun³

et al. 2009

Clinical Nuclear Medicine

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A 43-year-old man had complete AV block and syncope. Echocardiography revealed a cardiac tumor attaching to the interatrial septum and protruding into the left atrial and right atrial cavities. F-18 FDG-PET/CT was performed and was interpreted with contrast-enhanced CT in similar planes side by side. It revealed remarkably increased glucose metabolism in the right atrium, interatrial septum, left atrium, and in a mass protruding from the posterior aspect of pericardium. Regions with central necrosis were found but there was no evidence of pleural and lymph node involvement. Endometrial biopsy demonstrated diffuse large B cell lymphoma and primary cardiac lymphoma was diagnosed. Integration of PET/CT and contrastenhanced CT can play an important part in the evaluation of cardiac tumors since it makes differentiation of the intracardiac structures much easier and more precisely.

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“…Nuclear medicine techniques, particularly FDG-PET, may be used to identify neoplastic involvement of the pericardium. 123 It is also able to identify acute or chronic pericarditis and detect the burden of inflammatory tissue. 124…”

Section: Pericardial Diseasementioning

confidence: 99%

Multimodality imaging for cardiotoxicity: state of the art and future perspectives

Artico

Abiodun

Shiwani

et al. 2022

Journal of Cardiovascular Pharmacology

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Modern cancer therapies have significantly improved survival leading to a growing population of cancer survivors. Similarly, both conventional and newer treatments are associated with a spectrum of cardiovascular disorders with potential long-term sequelae. Prompt detection and treatment of these complications is, therefore, pivotal to enable healthy survivorship and reduce cardiovascular morbidity. Advanced multimodality imaging is a valuable tool for stratifying patient risk, identifying cardiovascular toxicity during and after therapy, and predicting recovery. This review summarizes the potential cardiotoxic complications of anticancer therapies and the multimodality approaches available in each case with special focus on newer techniques and the added value of biomarkers ultimately leading to earlier diagnosis and better prognostication.

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FDG PET in Primary Effusion Lymphoma (PEL) of the Pericardium

Cited by 13 publications

References 8 publications

Primary cardiac lymphoma: Utility of multimodality imaging in diagnosis and management

Primary cardiac lymphoma: Utility of multimodality imaging in diagnosis and management

Primary Cardiac Lymphoma Evaluated With Integration of PET/CT and Contrast-Enhanced CT

Multimodality imaging for cardiotoxicity: state of the art and future perspectives

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