title: Primary Epstein-Barr virus infection diffusing F18-fluorodeoxyglucose-positron emission tomography/computed tomography response monitoring of Hodgkin's disease: a case report.
abstract: BACKGROUND
  Hodgkin's disease is highly curable by radiotherapy and/or chemotherapy, but refractory disease or early relapses are rarely cured by conventional salvage therapy.
  
  
  METHODS
  We report a case of a 20-year-old Caucasian man, with a biopsy-proven intrapulmonary relapse of Hodgkin's disease, for whom salvage chemotherapy was administered. During salvage chemotherapy intense increased F18-fluorodeoxyglucose uptake was noticed in multiple lymph nodes and diffuse increased splenic uptake, suggesting chemotherapy-refractory disease. However, additional information obtained from the patient revealed he recently had met his first girlfriend. An asymptomatic primary Epstein-Barr virus infection was considered proven.
  
  
  CONCLUSIONS
  Interim F18-fluorodeoxyglucose-positron emission tomography/computed tomography is a strong prognostic factor for advanced Hodgkin's and may better identify those patients needing intensified chemotherapy. Related to the nonspecificity of F18-fluorodeoxyglucose, clinical awareness of the potential interference of intercurrent asymptomatic viral infections with treatment and remission status monitoring continues to be important in the interpretation of equivocal medical imaging results.
authors.affiliation: Department of Nuclear Medicine, Medical Center Leeuwarden, P,O, Box 850, 8901 BR Leeuwarden, The Netherlands. hans.balink@znb.nl.
authors.forename: Hans
authors.initials: H
authors.lastname: Balink
authors.forename: Mels
authors.initials: M
authors.lastname: Hoogendoorn
mesh_terms: D058345:Asymptomatic Infections; D020031:Epstein-Barr Virus Infections / Q000150:complications / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013154:Spleen / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18