Usefulness of FDG-PET to diagnose intravascular lymphomatosis presenting as fever of unknown origin.
Intravascular lymphomatosis (IVL) is a rare systemic disease characterized by proliferation of lymphoid cells within the lumina of small arteries, veins, and capillaries. Diagnosis requires skin, liver, lung, bone marrow, renal, meningeal, or brain vessel biopsy but is often made only when the illness has progressed or post mortem because early involvement of organs was not evident. We report a case of IVL presenting as fever of unknown origin (FUO). In this case, gallium scintigraphy and computed tomography (CT) showed no evidence of malignancy, whereas (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased FDG uptake in the sternum, left and right vertebra, humerus, femur, and especially ilium. The diagnosis was made on iliac bone marrow biopsy examination. FDG-PET was useful for the detection of spread of disease in a patient with IVL suffering from FUO.
Hoshino
A
A
Department of General Medicine, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan. linmei131@yahoo.co.jp
Kawada
E
E
Ukita
T
T
Itoh
K
K
Sakamoto
H
H
Fujita
K
K
Mantani
N
N
Kogure
T
T
Tamura
J
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D001854:Bone Marrow Cells / Q000276:immunology / Q000473:pathology; D001921:Brain / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005269:Femur / Q000000981:diagnostic imaging; D005335:Fever of Unknown Origin; D019788:Fluorodeoxyglucose F18; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging; D007085:Ilium / Q000000981:diagnostic imaging; D016130:Immunophenotyping; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D011241:Prednisone / Q000627:therapeutic use; D013131:Spine / Q000000981:diagnostic imaging; D013249:Sternum / Q000000981:diagnostic imaging; D014055:Tomography, Emission-Computed; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D014750:Vincristine / Q000627:therapeutic use
D019788:Fluorodeoxyglucose F18; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone