From the Department of Radiology, University of Louisville School of Medicine, Louisville, KY.
Clin Nucl Med. 2022 Aug 1;47(8):746-747. doi: 10.1097/RLU.0000000000004125. Epub 2022 Mar 18.
A man with history of chronic lymphocytic leukemia (CLL) in remission had multiple rapidly growing lumps in recent 2 months. FDG PET/CT demonstrated disseminated FDG-avid nodal and extranodal lesions including those in unusual locations such as the nasopharynx, salivary glands, lungs, gastric wall, peritoneum, bones, and muscles. Subsequent biopsy of the right axillary mass showed absolute lymphocytosis with focus of large B-cell lymphoma. Flow cytometric immunophenotyping demonstrated κ-restricted CLL and B-cell lymphoma, consistent with Richter transformation of CLL. FDG PET/CT images of this case illustrated the most severe and most disseminated nodal and extranodal involvements of Richter transformation in CLL.
一名慢性淋巴细胞白血病（CLL）缓解期的男性在最近 2 个月内出现多个快速生长的肿块。FDG PET/CT 显示弥漫性 FDG 摄取的淋巴结和结外病变，包括鼻咽部、唾液腺、肺部、胃壁、腹膜、骨骼和肌肉等不常见部位的病变。随后对右侧腋窝肿块进行的活检显示绝对淋巴细胞增多，伴有大 B 细胞淋巴瘤的焦点。流式细胞术免疫表型分析显示κ受限的 CLL 和 B 细胞淋巴瘤，与 CLL 的 Richter 转化一致。本例的 FDG PET/CT 图像显示了 CLL 中 Richter 转化最严重和最广泛的淋巴结和结外累及。
