Testicular fluorine-18 fludeoxyglucose uptake on positron emission tomography CT in patients with lymphoma: clinical significance and management impact

Sidhu, P; Lin, Peter; Son, Hyukmin; Rosenfeld, David; Lin, Michael

doi:10.1259/bjr.20140472

Cited by 14 publications

(13 citation statements)

References 24 publications

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“…FDG-PET/CT could be considered a useful adjunct to other imaging modalities in the diagnosis of testicular lymphoma [ 57 ] and could depict scrotal extension of peritoneal mesothelioma [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Imaging of the scrotum: beyond sonography

et al. 2018

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The aim of this article is to describe the role of second-level imaging techniques after an initial ultrasonography evaluation in the assessment of scrotal diseases. While ultrasonography remains central as the primary imaging modality for the evaluation of pathologic conditions of the scrotum, the role of magnetic resonance imaging continues to evolve: it can actually be valuable as a problem-solving tool when sonographic findings are equivocal or inconclusive. Magnetic resonance imaging of the scrotum may provide accurate detection and characterization of scrotal diseases, well depicting the precise location of scrotal masses (intratesticular or extratesticular) and reliably characterizing benign conditions simulating neoplastic processes, thus preventing unnecessary radical surgery. Advanced magnetic resonance techniques, most of all diffusion weighted imaging and magnetic resonance spectroscopy, play in the meanwhile a more significant role in evaluating scrotal diseases.Teaching points • Multiparametric ultrasonography usually represents the initial imaging modality for approaching scrotal diseases. • MRI is well established as a problem-solving tool for inconclusive sonographic findings. • Advanced MRI techniques can be successfully applied in scrotal pathology assessment. • MRI is valuable in differentiating benign conditions from neoplastic processes. • CT plays a role in trauma assessment and cancer staging alongside PET/CT.

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Section: Discussionmentioning

confidence: 99%

Imaging of the scrotum: beyond sonography

et al. 2018

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“…The clinical presentation of primary testicular DLBCL includes swelling of testis, B-symptoms (i.e., fever, night sweats and weight loss) and elevated LDH levels [4]. Typically, these tumors are characterized by a high risk to disseminate to the CNS, thereby warranting routine CNS prophylaxis with chemo-or radio-therapy [3,8].…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, patients treated with orchiectomy alone would mostly experience disease relapse within two years; 5-35% in the contralateral testis [20]. Additionally, relapses to distant extranodal sites, particularly to CNS, also remains a major therapeutic challenge [3,8]. In this context, we have planned doxorubicin-based chemotherapy for our patient.…”

Section: Discussionmentioning

confidence: 99%

“…In general, testicular DLBCL tumors are classified based on Cotswold modification of Ann Arbor staging system, where crucial disease parameters like tumor size, lymphadenopathy and regions of lymph node involvement are considered towards the assessment of overall clinical stage of the disease [7]. Primary testicular DLBCL has been reported to exhibit aggressive clinical behavior, poor prognosis and high tendency to disseminate to the central nervous system (CNS) and thereby related to high morbidity and mortality rates [3,8]. The hybrid 2-[fluorine-18] fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/ computed tomography (PET/CT) has become the standard imaging tool for initial staging and assessment of the treatment response in lymphoma patients [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Primary testicular diffuse large B-cell lymphoma: A case report

Sadiq

Ahmad

Shuja

et al. 2017

Egyptian Journal of Basic and Applied Sciences

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Primary testicular diffuse large-B cell lymphoma (DLBCL) is an uncommon and aggressive disease with predominant manifestation in the older age. Herein, we report a case of 47-year-old male patient who presented with three months history of left testis swelling. The patient underwent unilateral (left) radical orchiectomy. Histopathological examination revealed extensive involvement and replacement of testicular parenchyma by a tumor composed of large discohesive sheets of cells with pleomorphic, hyperchromatic nuclei and prominent nucleoli. Immunohistochemical (IHC) staining showed reactivity for LCA & Pan B (CD20) and negativity for OCT 3/4, SALL4 and Inhibin. Moreover, Pan T (CD3) highlighted reactive T-cells. These features rendered the diagnosis of DLBCL of testis. The hybrid 2-[fluorine-18] fluoro-2deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) demonstrated two para-aortic FDG avid lymph nodes on the left side at the level of L2 vertebra. Presently, the patient has been planned for doxorubicin-based chemotherapy (i.e., cyclophosphamide, doxorubicin, vincristine and prednisone; CHOP) along with intrathecal Methroxate (MTX), which would presumably improve the prognosis. Our study would expand the pool of this uncommon tumor towards its better understanding.

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“…Orchitis demonstrates intense FDG uptake and can be indistinguishable ( Figure 19) whereas GCT are less metabolically active (Figure 20). We describe four patterns of FDG avid PTL [(focal or multifocal, diffuse asymmetrical or symmetrical uptake 19 ( Figures 21-23)].…”

Section: Seminal Vesiclementioning

confidence: 99%

Genitourinary involvement of lymphomas on FDG-PET

Naik

Lin

2018

The British Journal of Radiology

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Primary extranodal lymphomatous involvement of the genitourinary tract is rare and secondary extranodal involvement in disseminated disease occurs more frequently. Imaging of metabolic activity with 2-(fluorine-18) fluoro-2-deoxy-d-glucose (FDG) used in PET facilitates the identification of these extranodal sites of disease, particularly in the absence of structural lesions on conventional imaging modalities. Primary extranodal lymphoma affecting the genitourinary system is often caused by high-grade Non-Hodgkin's Lymphoma (NHL) with the most common subtype being diffuse large B-cell lymphoma (DLBCL). Although rare, the incidence of extranodal lymphoproliferative disease is increasing and a delay in diagnosis holds a poor prognosis. Familiarity with benign and physiological causes of FDG uptake, particularly due to the urinary tracer excretion is crucial in identifying sites of lymphomatous involvement in the genitourinary system. Additionally, non-lymphomatous malignancies are usually treated surgically, whereas lymphoma is primarily treated with chemotherapy and/or radiotherapy. Therefore, accurate identification and staging together with histological confirmation significantly impacts management of these patients. This article serves to review and illustrate the imaging findings on FDG-PET/CT of primary extranodal lymphoma affecting the genitourinary system.

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Testicular fluorine-18 fludeoxyglucose uptake on positron emission tomography CT in patients with lymphoma: clinical significance and management impact

Abstract: Testicular fluorine-18 fludeoxyglucose uptake on positron emission tomography CT in patients with lymphoma: clinical significance and management impact. Br

Cited by 14 publications

References 24 publications

Imaging of the scrotum: beyond sonography

Imaging of the scrotum: beyond sonography

Primary testicular diffuse large B-cell lymphoma: A case report

Genitourinary involvement of lymphomas on FDG-PET

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