title: Gallium-67 uptake in a mass of benign transformation mimicking recurrence of nodular lymphocytic predominance Hodgkin's disease.
abstract: Gallium-67 is now widely used in the management of lymphoma patients. It is not, however, tumor-specific and reasons for uptake in nonmalignant and premalignant lesions associated with lymphoma should be recognized. Gallium-67 uptake in a mass of progressively transformed germinal centers and sarcoid-like reaction, mimicking recurrence in a 31-yr-old man with nodular lymphocytic predominance Hodgkin's disease, is described. Gallium-67 was taken up on two occasions and a recurrence was suspected. On the first occasion, abnormal uptake was present in axillary lymph nodes and on the second in mediastinal and parahilar lymph nodes. Histology of the lesions on both occasions showed progressively transformed germinal centers and sarcoid-like reaction but no evidence of Hodgkin's disease (HD). Bilateral parahilar abnormal uptake of 67Ga disappeared spontaneously without treatment after several months. The mass on CT regressed but did not disappear. This case demonstrates that the appearance of a new mass which takes up 67Ga in lymphocytic-predominance HD during a continuous clinical remission does not necessarily indicate recurrence and the need for treatment. It suggests that a biopsy should be performed to determine the nature of the lesion.
authors.affiliation: Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Bar-Shalom
authors.forename: Y
authors.initials: Y
authors.lastname: Ben-Arie
authors.forename: D
authors.initials: D
authors.lastname: Gaitini
authors.forename: R
authors.initials: R
authors.lastname: Epelbaum
authors.forename: S
authors.initials: S
authors.lastname: Parmett
authors.forename: O
authors.initials: O
authors.lastname: Israel
authors.forename: D
authors.initials: D
authors.lastname: Front
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005710:Gallium Radioisotopes; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging
chemical_list: D005710:Gallium Radioisotopes