Focus : Lymphoma
Clinical History
A male patient presented in 2005 with diffuse large B-cell lymphoma with high International
Prognostic Index (IPI). He was treated with R-CHOP regimen and achieved complete remission.
He was referred for a follow-up PET/CT scan six months later.
In an interval evaluation on the sixth month, the PET/CT scan revealed increased uptake in the
sacrum and biopsy confirmed relapse, as demonstrated by the images in Figure 1.
The patient was treated with RICE regimen followed by high-dose chemotherapy and autologous
stem cell transplant and achieved complete remission, as shown in the posttransplant PET
images on the lower row of Figure 2.
Discussion
This case shows how an interval follow-up PET/CT scan revealed that the patient had relapsed
with predominant bone involvement. Fortunately he was retreated and showed a response to the
salvage therapy.
This case clearly demonstrates the role of PET/CT scanning in routine follow-up of patients,
allowing a very accurate picture of the extent of recurrence. In addition, the PET/CT scan
confirmed the patient’s response to salvage therapy.
Data Courtesy of Dr. Mehdi Moezi, Integrated Community Oncology Network, Jacksonville, Florida.