title: Positron emission tomography findings in patients with lymphoma-associated haemophagocytic syndrome.
abstract: Lymphomas that manifest initially with haemophagocytic syndrome (HPS) often pose a diagnostic challenge, as the majority of cases have no significant lymphadenopathy for early histological diagnosis. There is paucity of data on specific features of fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography with integrated computed tomography (PET/CT) in patients with lymphoma-associated HPS (LHPS). We describe three cases of LHPS and their characteristic PET imaging features. These three patients had pyrexia and pancytopenia. Their PET/CT images showed extensive and diffuse FDG uptakes in the bone marrow of the axial skeleton, with little involvement in the lymph nodes. They also faced a common initial diagnostic difficulty; the lack of nodal involvement on clinical examination or CT contributed to the delay in the diagnosis of lymphoma. The PET/CT images, however, revealed extensive and distinctive FDG uptakes in the axial skeletal marrow compartment, thus leading to a greater appreciation of the full extent of the disease.
authors.affiliation: Department of Haematology, Singapore General Hospital, Outram Road, Singapore 169608. ryiu@yahoo.com
authors.forename: C R
authors.initials: CR
authors.lastname: Yiu
authors.forename: Y H
authors.initials: YH
authors.lastname: Kao
authors.forename: C
authors.initials: C
authors.lastname: Phipps
authors.forename: D
authors.initials: D
authors.lastname: Tan
mesh_terms: D000368:Aged; D005335:Fever of Unknown Origin / Q000209:etiology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000000981:diagnostic imaging* / Q000209:etiology; D008223:Lymphoma / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010198:Pancytopenia / Q000209:etiology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18