Monitoring lymphoma with PET
18F-FDG PET scanning is considered the standard of care for baseline staging and assessment of treatment response for higher grade lymphomas.
We reported a case in which an interim PET scan carried out after three cycles of chemotherapy appeared to suggest progressive disease, whereas further bone marrow biopsies, repeat 18F-FDG PET scanning and a white cell scan confirmed that the interim irregular scan was due to an unusual pattern of scattered islands of regenerating normal marrow.
Our case report highlighted that apparent severe bone marrow abnormalities on 18F-FDG PET scans in lymphoma patients treated with chemotherapy are not always due to disease. Clinicians should, therefore, retain a high index of suspicion for benign causes when 18F-FDG PET scan results appear incongruent with clinical response.
Cherk MH, Patil S, Beech P, Kalff V. Heterogeneous bone marrow uptake on interim 18F-FDG- PET for lymphoma mimicking disease progression: a case report. J Med Case Rep. 2014;8:362.