Hepatitis C-related primary effusion lymphoma of the pleura and peritoneum, imaged with F-18 FDG PET/CT.
Primary Effusion Lymphoma (PEL) is a rare form of Non-Hodgkin lymphoma that involves serous body cavities (pleural, pericardial, or peritoneal) with lymphomatous effusions in the absence of lymphadenopathy or organomegaly. Although it was seen mostly in HIV-positive patients, it has recently been reported in HIV-negative patients with chronic Hepatitis B or C infections. PEL is associated with human herpes virus type-8 infection, often presents with rapidly progressive effusions and generally has a poor prognosis. This is a case of a 65-year-old HIV-negative man with Hepatitis C cirrhosis, who presented with abdominal pain. An F-18 FDG PET/CT showed marked ascites and pleural effusions with increased F-18 FDG uptake in the pleura and peritoneum on the left side. Analysis of the cells in the peritoneal fluid revealed a human herpes virus 8-positive PEL of the peritoneum. As a result the patient was no longer considered a liver transplant candidate and died 2 weeks after the diagnosis.
Makis
William
W
Department of Nuclear Medicine, Jewish General Hospital, McGill University, Montreal, QC, Canada. makisw79@yahoo.com
Stern
Jerry
J
D000368:Aged; D019788:Fluorodeoxyglucose F18; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D054685:Lymphoma, Primary Effusion / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D010534:Peritoneal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010997:Pleural Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18