Utility of PET/CT for therapy response assessment in non-Hodgkin's lymphoma

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sally Mahmoud Abdel-Aziz Abdel-Aziz ◽  
Safaa Kamal Mohamed BadrElden ◽  
Asmaa Magdy Mohamed Salama
Keyword(s):  
Ct Scan ◽  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Whole Body ◽  
Non Hodgkin’S Lymphoma ◽  
Contrast Enhanced Ct ◽  
Pet Ct ◽  
Non Hodgkin's Lymphoma ◽  
Enhanced Ct

Abstract Aim of the study to evaluate the role of PET/CT in initial diagnosis and staging of lymphoma, and to determine the predictive value of 18F-FDG PET by monitoring the early response and final response after completion of chemotherapy in patients with non-Hodgkin's lymphoma. Patient and Methods our prospective study included 25 patients with pathologically confirmed nonHodgkin Lymphoma diffuse large B cell lymphoma selected from Department of Radiology at Ain Shams University Hospital from January 2019 to March 2020. The patients included in this study performed the followings: Initial PET/CT for staging, interim PET/CT and end of the treatment PET/CT. We performed low dose non enhanced CT scan first, then a whole body PET study followed by diagnostic enhanced whole body CT scan. The whole study took approximately 20-30 minutes. Results PET/CT has greater sensitivity 100% and specificity 68.8% than CT alone for detecting sites of nodal and extra-nodal involvement and for assessment of therapeutic response in non-Hodgkin lymphoma. Conclusion PET / CT is an accurate method for evaluating tumor viability in the post-therapy setting of Non-Hodgkin lymphomas. PET / CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to contrast enhanced CT.

scholarly journals Sarcoid-Like Reaction in Non-Hodgkin’s Lymphoma—A Diagnostic Challenge for Deauville Scoring on 18F-FDG PET/CT Imaging

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1009
Author(s):  
Michael Winkelmann ◽  
Kai Rejeski ◽  
Marion Subklewe ◽  
Jens Ricke ◽  
Marcus Unterrainer ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Ct Imaging ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Pet Ct ◽  
Non Hodgkin's Lymphoma ◽  
18F Fdg ◽  
Fdg Pet Ct

The sarcoid-like reaction represents an autoinflammatory cause of mediastinal and hilar lymphadenopathy but may also involve other lymph node regions and organs. This rare phenomenon has mainly been reported in patients with Hodgkin’s lymphoma (HL) or solid tumors (particularly melanoma) undergoing immunotherapy and chemotherapy. Cases in non-Hodgkin’s lymphoma (NHL) are very uncommon. We present an uncommon case of a patient with primarily mediastinal diffuse large B-cell lymphoma (DLBCL) who showed a CT-based partial response in interim staging, whereas at end-of-treatment multiple newly enlarged and hypermetabolic mediastinal and bilateral hilar lymph nodes were detected by 18F-FDG PET/CT imaging. A subsequent histological workup determined a sarcoid-like reaction without any lymphomatous tissue. Therefore, sarcoid-like reactions should be considered as a potential pitfall in Deauville staging with 18F-FDG PET/CT imaging for patients with NHL.

Clinical Utility of Radioimmunoscintigraphy of Non-Hodgkin's Lymphoma with Radiolabelled LL2 Monoclonal Antibody., Lymphoscan™: Preliminary Results

1995 ◽  
Vol 81 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Massimo Gasparini ◽  
Emilio Bombardieri ◽  
Carlo Tondini ◽  
Lorenzo Mattioli ◽  
Lynne Hughes ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Clinical Staging ◽  
Whole Body ◽  
Low Grade ◽  
Fab Fragment ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Aims and Background Adequate clinical staging of non-Hodgkin's lymphoma patients is essential because only localized disease can be treated satisfactorily. Many imaging procedures are necessary to stage the disease accurately. The objective of this study was to evaluate the efficacy of an anti-lymphoma antibody in the Fab’ fragment form, labelled with 99mTc, to detect malignant lesions. Methods Radioimmunodetection (RAID) with 99mTc-labelled B-cell lymphoma monoclonal antibody IMMU-LL2-Fab’ (LymphoSCAN™; Immunomedics, Morris Plain, NJ, USA) was investigated in 10 patients (5 females and 5 males; age range, 20-72 years) with histologically proved non-Hodgkin's lymphoma. Of the 10 lymphomas, 7 were intermediate grade and 3 were low grade. Whole body images with multiple planar views were obtained at 30 min, 4-6 and 24 h after i.v. injection of 1 mg LL2-Fab’ labelled with 740-925 MBq of 99mTc. SPET of the chest or abdomen was performed in all patients 5-8 h after the immunoreagent injection. Results No adverse reactions were observed in any patient after Mab infusion, and no appreciable changes were seen in the blood counts, renal or liver function tests. A total of 18 of 21 (85.7%) lymphoma lesions were detected by RAID. All the tumor localizations were confirmed by clinical examination and with other imaging techniques, such as CT scan, MRI or gallium scan. In this series of patients no false-positive results were noted. As regards the biodistribution of the immunoreagent, no appreciable bone marrow activity was seen; splenic targeting was demonstrated in all patients; the tumor-to-non-tumor ratios ranged from 1.2 to 2.8 ad measured by the ROI technique; no difference in uptake was noted for different tumor grades. The images obtained 24 h after injection did not reveal new lesions, but areas of doubtful uptake were seen as positive focal areas in the delayed scan. Conclusions LymphoSCAN™ seems to be useful for detection, staging and follow-up of non-Hodgkin's lymphoma patients.

Non-Hodgkin's Lymphoma Presenting as an Isolated Vertebral Collapse

2017 ◽  
Vol 16 (01) ◽  
pp. 025-028
Author(s):  
Namit Singhal ◽  
Anu Chawla ◽  
Vinay Agarwal
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Rare Condition ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Vertebral Collapse ◽  
Non Hodgkin’S Lymphoma ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Non Hodgkin's Lymphoma ◽  
Vertebral Involvement

AbstractNon-Hodgkin's lymphoma (NHL) presenting as an isolated vertebral collapse is a very rare condition. We present a case of non-Hodgkin's lymphoma presenting as L3 vertebral body collapse on MRI. Isolated vertebral involvement was seen without evidence of any lesion elsewhere. Workup for systemic evidence of malignancy with contrast-enhanced CT of chest and abdomen did not reveal any other lesion. The patient was operated for L3 transpedicular decompression and L2–L4 pedicle screw rod fixation. Biopsy revealed diffuse large B cell lymphoma (DLBCL), NOS. Diagnosis was further confirmed by a postoperative PET scan, which showed multiple deposits in perinephric fat and retroperitoneal lymph nodes. Patient was treated with CHOP-based chemotherapy.

scholarly journals Non–Hodgkin’s Lymphoma of the Appendix

2015 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
G. A. Watson ◽  
J. Gleeson ◽  
D. Kelly ◽  
D. Byrne ◽  
P. De La Harpe-Golden ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Hodgkins Lymphoma ◽  
Large B Cell Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Pet Ct ◽  
Non Hodgkin's Lymphoma ◽  
History Of ◽  
Non Hodgkins Lymphoma

AbstractInfiltration of the appendix as a manifestation of non-hodgkins lymphoma (NHL) at diagnosis or at relapse is a rare finding. We report the history of a patient with gastrointestinal non-hodgkin's lymphoma treated 8 years earlier who presented with symptoms suggestive of acute appendicitis secondary to relapsed NHL.Keywords: Non Hodgkins Lymphoma, Diffuse Large B Cell Lymphoma, appendix, PET CT

scholarly journals Use of pembrolizumab with or without pomalidomide in HIV-associated non-Hodgkin’s lymphoma

2021 ◽  
Vol 9 (2) ◽  
pp. e002097
Author(s):  
Kathryn Lurain ◽  
Ramya Ramaswami ◽  
Ralph Mangusan ◽  
Anaida Widell ◽  
Irene Ekwede ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hiv And Aids ◽  
Hodgkin's Lymphoma ◽  
People Living With Hiv ◽  
Oncogenic Viruses ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

BackgroundNon-Hodgkin’s lymphoma (NHL) is currently the most common malignancy among people living with HIV (PLWH) in the USA. NHL in PLWH is more frequently associated with oncogenic viruses than NHL in immunocompetent individuals and is generally associated with increased PD-1 expression and T cell exhaustion. An effective immune-based second-line approach that is less immunosuppressive than chemotherapy may decrease infection risk, improve immune control of oncogenic viruses, and ultimately allow for better lymphoma control.MethodsWe conducted a retrospective study of patients with HIV-associated lymphomas treated with pembrolizumab±pomalidomide in the HIV and AIDS Malignancy Branch, Center for Cancer Research, National Cancer Institute.ResultsWe identified 10 patients with stage IV relapsed and/or primary refractory HIV-associated NHL who were treated with pembrolizumab, an immune checkpoint inihibitor, with or without pomalidomide. Five patients had primary effusion lymphoma (PEL): one had germinal center B cell-like (GCB) diffuse large B cell lymphoma (DLBCL); two had non-GCB DLBCL; one had aggressive B cell lymphoma, not otherwise specified; and one had plasmablastic lymphoma. Six patients received pembrolizumab alone at 200 mg intravenously every 3 weeks, three received pembrolizumab 200 mg intravenously every 4 weeks plus pomalidomide 4 mg orally every day for days 1–21 of a 28-day cycle; and one sequentially received pembrolizumab alone and then pomalidomide alone. The response rate was 50% with particular benefit in gammaherpesvirus-associated tumors. The progression-free survival was 4.1 months (95% CI: 1.3 to 12.4) and overall survival was 14.7 months (95% CI: 2.96 to not reached). Three patients with PEL had leptomeningeal disease: one had a complete response and the other two had long-term disease control. There were four immune-related adverse events (irAEs), all CTCAEv5 grade 2–3; three of the four patients were able to continue receiving pembrolizumab. No irAEs occurred in patients receiving the combination of pembrolizumab and pomalidomide.ConclusionsTreatment of HIV-associated NHL with pembrolizumab with or without pomalidomide elicited responses in several subtypes of HIV-associated NHL. This approach is worth further study in PLWH and NHL.

scholarly journals Case of extranodal non-hodgkins lymphoma involving the endometrium and the ovaries: a rare case report

2017 ◽  
Vol 6 (9) ◽  
pp. 4131 ◽  
Author(s):  
Lakshmi Manjeera Malempati ◽  
Neetha Nandan ◽  
Sagarika Babu
Keyword(s):  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Female Genital Tract ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Western World ◽  
Non Hodgkin’S Lymphoma ◽  
Uterine Neoplasm ◽  
Non Hodgkin's Lymphoma ◽  
Large B Cell

Non-Hodgkin’s lymphoma(NHL) is most commonly encountered during childhood and rarely among the adults. Primary malignant lymphoma in the female genital tract are rare Moreover they present with non-specific symptoms and hence there may be delay in the diagnosis. It is difficult to distinguish this condition from the more common uterine neoplasm such as uterine fibroids or sarcoma. Diffuse large B-cell lymphoma (DLBCL) is most commonly seen among the cases of NHL, contributing to among one third of NHL in the western world. DLBCL is common in elderly population. A 69-year-old postmenopausal woman who came with watery discharge since, 15 days was evaluated clinically and radiologically and was found to have thickened endometrium and enlarged ovaries, for which endometrial biopsy was taken that showed non-secretory endometrium with atrophic changes. Tumor markers found to be normal. TAH+BSO was done and the histopathology showed Non-Hodgkin’s lymphoma, diffuse large B cell type of the endometrium and both ovaries which was confirmed by immune histochemical marker study. PET-CT was done that showed metabolically active para aortic and common iliac lymph nodes thereby she was diagnosed with stage II (Ann Arbor Staging) non-Hodgkin’s lymphoma, hence she received 6 cycles of R-CHOP. As evident in our case, non-Hodgkin’s Lymphoma of the endometrium and the ovaries being an extremely rare condition, high-degree of suspicion is required for its prompt diagnosis and treatment.

Multicenter Phase II Clinical Study of Iodine-131–Rituximab Radioimmunotherapy in Relapsed or Refractory Indolent Non-Hodgkin’s Lymphoma

2006 ◽  
Vol 24 (27) ◽  
pp. 4418-4425 ◽  
Author(s):  
Michael F. Leahy ◽  
John F. Seymour ◽  
Rodney J. Hicks ◽  
J. Harvey Turner
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Progression Free Survival ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
Whole Body ◽  
Actuarial Survival ◽  
Entire Cohort ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Iodine 131

Purpose To evaluate efficacy and safety of iodine-131 (131I) –rituximab chimeric anti-CD20 antibody radioimmunotherapy in patients with relapsed or refractory indolent non-Hodgkin's lymphoma (NHL). Patients and Methods After a standard loading dose of rituximab 375 mg/m2, individualized dosimetry was performed by whole-body gamma imaging of a tracer activity of 131I-rituximab followed by administration of a therapeutic activity of 131I-rituximab to deliver an estimated whole-body radiation absorbed dose of 0.75 Gy. Results Ninety-one patients were entered onto the trial: 78 patients (86%) had follicular lymphoma, six patients (7%) had mucosa-associated lymphoid tissue/marginal zone lymphoma, and seven patients (8%) had small lymphocytic lymphoma. The objective overall response rate (ORR) was 76%, with 53% attaining a complete response (CR) or CR unconfirmed (CRu). Median duration of response for patients achieving CR/CRu was 20 v 7 months for those with a partial response (P = .0121). Median progression-free survival for the entire cohort was 13 months, with 14% remaining relapse free beyond 4 years. Median follow-up was 23 months, with a 4-year actuarial survival rate of 59% ± 10%. Toxicity was principally hematologic; grade 4 thrombocytopenia occurred in 4% and neutropenia occurred in 16% of patients, with nadirs at 6 to 7 weeks after treatment. Conclusion 131I-rituximab radioimmunotherapy of relapsed or refractory indolent NHL achieves high ORR and CR rates with minimal toxicity.

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