Spontaneous regression of follicular, mantle cell, and diffuse large B-cell non-Hodgkin's lymphomas detected by FDG-PET imaging.
Spontaneous regression of non-Hodgkin lymphoma (NHL) has been reported in low-grade tumors but is an extremely rare event in intermediate- and high-grade disease. Documentation of spontaneous regression by serial fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging has not been reported in the literature. We present 3 cases of spontaneous regression, 1 each of follicular lymphoma (FL), mantle cell lymphoma (MCL), and diffuse large B-cell lymphoma (DLBCL), which showed spontaneous regression on serial FDG-PET imaging. All patients underwent serial whole-body FDG-PET scans 60 minutes after intravenous injection of 9-11 mCi of this radiotracer. None of them had any chemotherapy, radiotherapy, or surgery after the baseline PET scan. Spontaneous regression of disease in all 3 cases was correlated with conventional imaging and clinical course. All 3 patients had positive FDG-PET results on their baseline scan. There was complete disappearance of FDG uptake on a follow-up PET scan for the patient with follicular lymphoma. These results suggest complete regression. The patients with MCL and DLBCL both showed a significant reduction in FDG uptake on serial whole-body PET scans, suggesting partial regression in both cases. Although spontaneous regression of lymphoma is uncommon, this phenomenon can be successfully demonstrated by FDG-PET imaging. Therefore, serial PET imaging may play an important role in detecting this unusual event and may further enhance our understanding of the biologic behavior of this malignancy.
Division of Nuclear Medicine, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Rakesh
R
Kumar
Peeyush
P
Bhargava
Hongming
H
Zhuang
Jian Q
JQ
Yu
Stephen J
SJ
Schuster
Abass
A
Alavi
D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging*; D020522:Lymphoma, Mantle-Cell / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18