Vital Hepatic Lymphoma Residuum or Excessive Immune Response? Challenging Treatment Decisions in a Patient With Systemic Lupus Erythematosus and Liver-Dominant Diffuse Large B-Cell Lymphoma: Case Report.

Autor:	Kurch L; Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany., Georgi TW; Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany., Monecke A; Department of Pathology, University Hospital Leipzig, Leipzig, Germany., Seehofer D; Department of Visceral, Transplant, Thoracic, and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany., Borte G; Department of Radiology, University Hospital Leipzig, Leipzig, Germany., Sabri O; Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany., Kluge R; Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany., Heyn S; Department of Hematology, Cellular Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany., Pierer M; Department of Rheumatology, University Hospital Leipzig, Leipzig, Germany., Platzbecker U; Department of Hematology, Cellular Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany., Kayser S; Department of Hematology, Cellular Therapy and Hemostaseology, University Hospital Leipzig, Leipzig, Germany.; NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2022 Jan 18; Vol. 11, pp. 798757. Date of Electronic Publication: 2022 Jan 18 (Print Publication: 2021).
DOI:	10.3389/fonc.2021.798757
Abstrakt:	A 28-year-old female patient with active and difficult-to-treat systemic lupus erythematosus (SLE) was diagnosed with liver-dominant diffused large B-cell lymphoma. Repeated response 18 F-FDG-PET studies showed persistently high, and, despite intensified immunochemotherapy, further increasing metabolic activity of one of the hepatic lymphoma residuals, whereas all other initial lymphoma manifestations had achieved complete metabolic remission. As biopsy of the 18 F-FDG-PET-positive liver residual turned out to be inconclusive, complete resection was performed. Subsequent histopathological examination, however, revealed only necrotic tissue. Thus, no further lymphoma treatment was scheduled. The patient undergoes regular surveillance and is disease-free 13 months after resection. Similarly, treatment of SLE is no longer required due to lack of activity already after the first two cycles of lymphoma treatment. The case shows how closely SLE and diffused large B-cell lymphoma can be connected and stresses the importance of interdisciplinary treatment approaches. In the future, artificial intelligence may help to further classify 18 F-FDG-PET-positive lymphoma residuals. This could lead to an increase of the positive predictive value of interim- and end-of-treatment 18 F-FDG-PET. The patient's point of view enables another instructive perspective on the course of treatment, which often remains hidden to treating physicians due to lack of time in clinical routine. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Kurch, Georgi, Monecke, Seehofer, Borte, Sabri, Kluge, Heyn, Pierer, Platzbecker and Kayser.)
Databáze:	MEDLINE
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