Hsiao Yeong-Shin, Shen Shu-Chane, Hsiao Shih-Chuan
Department of Internal Medicine, St. Marien- and St. Anna Foundation Hospital, Ludwigshafen, Germany.
Department of Nuclear Medicine, St. Martin de Porres Hospital, Chiayi, Taiwan.
Am J Case Rep. 2024 Apr 22;25:e943275. doi: 10.12659/AJCR.943275.
BACKGROUND Marginal zone lymphoma is a low-grade, B-cell, non-Hodgkin lymphoma. Bone marrow involvement (BMI) of leukemia or lymphoma can usually be displayed in fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) with high standardized uptake values (SUV), while diffuse homogeneous ¹⁸F-FDG bone marrow uptake (BMU) in PET/CT primarily reflects hyperplastic bone marrow status. This report is of a 74-year-old man presenting with anemia and a diagnosis of recurrent marginal zone lymphoma with bone marrow involvement identified with 18F-FDG PET/CT imaging and biopsy. CASE REPORT A 64-year-old man with severe anemia and body weight loss of 7 kg in 1 month was diagnosed with marginal zone lymphoma, stage III, in July 2011. He went into complete remission in April 2012 after 6 cycles of chemotherapy, with Hb restored. Anemia and diffuse homogeneous ¹⁸F-FDG BMU in PET/CT were then noted during a routine check-up in October 2021, and recurrent disease was established through positive biopsy of subcutaneous nodules and bone marrow. Subsequent complete remission after 6 cycles of combination therapy was validated with pathologically negative BMI, the resolution of the slightly enhanced ¹⁸F-FDG BMU in PET/CT, and restored hemoglobin. CONCLUSIONS This report has highlighted the importance of follow-up for patients with lymphoma and supports the diagnostic role of ¹⁸F-FDG PET/CT imaging and the pathological verification in identifying malignant involvement in bone marrow.
背景 边缘区淋巴瘤是一种低度恶性的B细胞非霍奇金淋巴瘤。白血病或淋巴瘤的骨髓受累情况（BMI）通常可在氟-18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸F-FDG PET/CT）中显示出高标准化摄取值（SUV），而PET/CT中弥漫性均匀的¹⁸F-FDG骨髓摄取（BMU）主要反映骨髓增生状态。本文报告了一名74岁男性，因贫血就诊，经¹⁸F-FDG PET/CT成像及活检确诊为复发性边缘区淋巴瘤伴骨髓受累。病例报告 一名64岁男性，患有严重贫血，1个月内体重减轻7 kg，于2011年7月被诊断为III期边缘区淋巴瘤。经过6个周期的化疗后，他于2012年4月完全缓解，血红蛋白恢复正常。2021年10月的一次常规检查中发现贫血及PET/CT中弥漫性均匀的¹⁸F-FDG BMU，通过皮下结节和骨髓活检阳性确诊为疾病复发。经过6个周期的联合治疗后再次完全缓解，通过病理检查BMI为阴性、PET/CT中¹⁸F-FDG BMU轻度增强消失以及血红蛋白恢复正常得以证实。结论 本报告强调了淋巴瘤患者随访的重要性，并支持¹⁸F-FDG PET/CT成像及病理检查在识别骨髓恶性受累中的诊断作用。
