title: Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma.
abstract: A 32-year-old male patient was diagnosed with nodular lymphocyte-predominant Hodgkin lymphoma. Staging FDG PET-CT detected a large right axillary lymph node conglomerate and splenic manifestation. Interim PET-CT following two cycles of ABVD chemotherapy revealed good metabolic response with the exception of a single axillary lymph node. A second "interim" PET-CT after two further cycles showed a similar result. A biopsy of the metabolically active non-palpable lymph node was performed using radioguided occult lesion localization (ROLL) with ultrasound guidance. The lymph node was successfully removed by minimally invasive surgery. Histological evaluation of the lymph node revealed a T cell-rich diffuse large B cell lymphoma. Based on this finding, a more aggressive treatment regimen followed by high dose chemotherapy with autologous stem cell rescue was adopted. To our knowledge, this is the first report of a lymphoma case in which the ROLL method was used in the radioguided biopsy of a chemoresistant lymph node detected by interim FDG PET-CT.
authors.affiliation: Department of Diagnostic Radiology and Oncotherapy, Semmelweis University, Üllői út 78/a, Budapest, 1082, Hungary. gyorke@radi.sote.hu.|PET-CT Medical, Diagnostic Ltd., Laky Adolf u. 44-46, Budapest, 1145, Hungary. gyorke@radi.sote.hu.
authors.forename: Tamás
authors.initials: T
authors.lastname: Györke
authors.affiliation: Department of Diagnostic Radiology and Oncotherapy, Semmelweis University, Üllői út 78/a, Budapest, 1082, Hungary.
authors.forename: Attila
authors.initials: A
authors.lastname: Kollár
authors.affiliation: Department of Dermatology, Dermatooncology and Venerology, Semmelweis University, Mária u. 41, Budapest, 1085, Hungary.
authors.forename: Gyula
authors.initials: G
authors.lastname: Bottlik
authors.affiliation: 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.
authors.forename: Ágota
authors.initials: Á
authors.lastname: Szepesi
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital of Budapest, Gyáli út 5-7, Budapest, 1097, Hungary.
authors.forename: Imre
authors.initials: I
authors.lastname: Bodó
authors.affiliation: Department of Haematology and Stem Cell Transplantation, St. István and St. László Hospital of Budapest, Gyáli út 5-7, Budapest, 1097, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Masszi
authors.affiliation: Department of Diagnostic Radiology and Oncotherapy, Semmelweis University, Üllői út 78/a, Budapest, 1082, Hungary.
authors.forename: Viktor
authors.initials: V
authors.lastname: Bérczi
authors.affiliation: PET-CT Medical, Diagnostic Ltd., Laky Adolf u. 44-46, Budapest, 1145, Hungary.
authors.forename: Ildikó
authors.initials: I
authors.lastname: Garai
mesh_terms: D000328:Adult; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18