Osteonecrosis in an adolescent with non-Hodgkin lymphoma resembling a new metastatic lesion on (18)F-FDG PET/CT.
Osteonecrosis may result from complications in a variety of pediatric diseases and, in the early stages of healing, may be characterized by inflammation and hyperemia. While traditionally assessed by bone scintigraphy, osteonecrosis may also present upon [F-18]2-fluoro-2-deoxyglucose PET/CT. Differentiation of osteonecrosis from metastatic lesions is important to ensure accurate disease staging and to avoid unnecessary imaging and biopsy. Osteonecrosis typically presents at the interface of weight-bearing joints after prolonged chemotherapy with corticosteroid administration, although prevalence is greater in adults than in children. We describe a case of unilateral osteonecrosis in the tibia of an adolescent lymphoma patient, which first presented on FDG-PET/CT imaging after 2 months of combination chemotherapy with corticosteroid administration. This report should aid in recognizing rapid-onset osteonecrosis with atypical sites of involvement in pediatric patients.
Hong
Terence S
TS
Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.
Shammas
Amer
A
Navarro
Oscar M
OM
Punnett
Angela
A
D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D003937:Diagnosis, Differential; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D010020:Osteonecrosis / Q000175:diagnosis* / Q000209:etiology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
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