PET positive generalized lymphadenopathy and splenomegaly following interferon-alfa-2b adjuvant therapy for melanoma.
Interferon-alfa (IFN-alpha) is used in patients with various inflammatory and neoplastic disorders. We recently encountered fluorodeoxyglucose (FDG) uptake in generalized lymphadenopathy, splenomegaly, and the marrow in a patient receiving high dose interferon-alpha-2b (IFN-alpha) as adjuvant therapy for the treatment of malignant melanoma. Biopsy of an enlarged hypermetabolic axillary lymph node revealed only a reactive node. Discontinuation of IFN-alpha caused regression of splenomegaly and lymphadenopathy within 3 months.A marrow "hyperstimulation" pattern that can include the spleen is a well-recognized phenomenon on (fluorodeoxyglucose) FDG positron emission tomography/computed tomography (PET/CT) scans in patients receiving chemotherapeutic agents like interferon, though classically due to colony stimulating factors, but does not generally include lymphadenopathy. This case, which likely reflects an interferon-induced pseudolymphoma, highlights the importance of a drug history and clinical correlation for the proper interpretation of FDG PET/CT scans.
Cone
Lawrence A
LA
Department of Medicine, Eisenhower Medical Center, Rancho Mirage, CA 92270, USA.
Brochert
Adam
A
Schulz
Karl
K
Stone
Richard A
RA
Kazi
Asma
A
Greene
David
D
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008206:Lymphatic Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D008545:Melanoma / Q000188:drug therapy; D049268:Positron-Emission Tomography; D011994:Recombinant Proteins; D012878:Skin Neoplasms / Q000188:drug therapy; D013163:Splenomegaly / Q000139:chemically induced* / Q000000981:diagnostic imaging*
D000970:Antineoplastic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins