A Case of Low-Grade Primary Cardiac Lymphoma with Pericardial Effusion Diagnosed by Combined 18F-Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography (FDG-PET/CT) Imaging and Effusion Cytology
Autor: | Chiaki Terao, Yasuyuki Taki, Hisanori Fukunaga, Tomoko Totsune, Tatsushi Mutoh, Hideo Shimomura, Shuzo Yamamoto, Yasuko Tatewaki, Manabu Nakagawa |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Pleural effusion medicine.medical_treatment Whole body imaging Pericardial effusion 030218 nuclear medicine & medical imaging Heart Neoplasms 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Cardiac tamponade medicine Humans Whole Body Imaging Aged medicine.diagnostic_test business.industry Lymphoma Non-Hodgkin Articles General Medicine Adenolymphoma medicine.disease Pleural Effusion Malignant Lymphoma Effusion Pericardiocentesis Positron emission tomography Positron-Emission Tomography 030220 oncology & carcinogenesis Female Radiology Radiopharmaceuticals business |
Zdroj: | The American Journal of Case Reports |
ISSN: | 1941-5923 |
Popis: | Patient: Female, 72 Final Diagnosis: Primary cardiac lymphoma Symptoms: Cardiac tamponade • dyspnea Medication: — Clinical Procedure: FDG-PET/CT scan Specialty: Nuclear Medicine Objective: Rare disease Background: Primary cardiac lymphoma is rare and can be an aggressive disease, depending on the grade. A case is reported of low-grade primary cardiac lymphoma associated with a pericardial effusion. 18F-fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) imaging was useful in the diagnosis and in evaluating the disease activity in this case. Case Report: A 72-year-old Japanese woman visited a general practitioner, complaining of dyspnea associated with cardiac tamponade. Pericardiocentesis was performed, and Group V malignant cells were identified by cytology, suspicious for malignant lymphoma. Whole-body FDG-PET/CT scans showed no pleural effusion or lymph node metastasis supporting the diagnosis of primary cardiac lymphoma diagnosed on pericardial effusion. The laboratory investigations showed that levels of serum soluble interleukin-2 (IL-2) receptor (sIL-2R), a diagnostic and prognostic marker for malignant lymphoma, were not elevated (258 U/ml). A six-month follow-up FDG-PET/CT scan showed an increased volume of the pericardial effusion and mild but abnormal uptake diffusely in the pericardial space, and the sIL-2R was slightly elevated (860 U/ml). No abnormal FDG accumulation outside the retained pericardial effusion was noted, which was compatible with a clinical picture of low-grade primary cardiac lymphoma, and in a period of watchful waiting during the first two years later, the sIL-2R had reduced to 195 U/ml. Conclusions: This is a rare case of low-grade primary cardiac lymphoma detected in a pericardial effusion, and highlights the utility of the FDG-PET/CT scan as a valuable diagnostic and follow-up modality. |
Databáze: | OpenAIRE |
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