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18F-FDG PET/CT in a bilateral lacrimal gland infiltration of mantle cell lymphoma
18F-FDG PET/TC en un caso de infiltración lacrimal bilateral por linfoma de células del manto
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Las imágenes mostraron 2 lesiones intraorbitarias bilaterales (A) que continuaban evidenciándose en el estudio con <span class="elsevierStyleSup">18</span>F-FDG como 2 depósitos patológicos del trazador en ambas glándulas lacrimales (B), así como la existencia de adenopatías hipermetabólicas supradiafragmáticas (C y D), todo ello sugestivo de malignidad. El estudio de anatomía patológica de glándula lacrimal con hematoxilina-eosina (E) mostró una infiltración linfoide centrocítica difusa.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Martínez-Esteve, F.J. García-Gómez, J.J. Borrero-Martin, E. Fajardo-Pico, I. Borrego-Dorado" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Martínez-Esteve" ] 1 => array:2 [ "nombre" => "F.J." "apellidos" => "García-Gómez" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Borrero-Martin" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Fajardo-Pico" ] 4 => array:2 [ "nombre" => "I." 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PET/MR imaging fusion by means of software (SPM8). PET imaging with <span class="elsevierStyleSup">11</span>C-Methionine. MR shows a rounded lesion located at the genu of corpus callosum measuring 22<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>18, with adjacent bilateral frontal angiogenic edema, consistent with local recurrence. PET with <span class="elsevierStyleSup">11</span>C-Methionine shows hypermetabolic lesion (SUV target/background ratio is 5.6/1.6), thus confirming tumor recurrence. Quantification was achieved through relationship between uptake avidity of the lesion (SUV maximum) and background of gray substance of the healthy contralateral lobe (SUV mean). (B) Imaging study after Bevacizumab treatment: T1-weighted and Flair sequences MR imaging. PET/MR imaging fusion by means of software (SPM8). PET imaging with <span class="elsevierStyleSup">11</span>C-Methionine. MR shows an increase of size at the lesion located at the genu of corpus callosum (27<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>24), with similar perilesional edema spread. The PET study with <span class="elsevierStyleSup">11</span>C-Methionine shows normalization of previous metabolic activity in lesion, thus confirming response to antiangiogenic treatment, and therapy was carried on with no further suspicious signs of recurrence in our patient.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.R. García, M. Baquero, P. Bassa, M. Soler, M. Moragas, E. Riera" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.R." "apellidos" => "García" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Baquero" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Bassa" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Soler" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Moragas" ] 5 => array:2 [ "nombre" => "E." 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Yang, B.D. Nguyen, M.C. Roarke" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Yang" ] 1 => array:2 [ "nombre" => "B.D." "apellidos" => "Nguyen" ] 2 => array:2 [ "nombre" => "M.C." "apellidos" => "Roarke" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000968?idApp=UINPBA00004N" "url" => "/22538089/0000003400000006/v1_201510310036/S2253808915000968/v1_201510310036/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Interesting images</span>" "titulo" => "<span class="elsevierStyleSup">18</span>F-FDG PET/CT in a bilateral lacrimal gland infiltration of mantle cell lymphoma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "396" "paginaFinal" => "397" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Martínez-Esteve, F.J. García-Gómez, J.J. Borrero-Martin, E. Fajardo-Pico, I. Borrego-Dorado" "autores" => array:5 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Martínez-Esteve" "email" => array:1 [ 0 => "andres.martinez.esteve@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F.J." "apellidos" => "García-Gómez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.J." "apellidos" => "Borrero-Martin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "E." "apellidos" => "Fajardo-Pico" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "I." "apellidos" => "Borrego-Dorado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Radiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "<span class="elsevierStyleSup">18</span>F-FDG PET/TC en un caso de infiltración lacrimal bilateral por linfoma de células del manto" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1887 "Ancho" => 3000 "Tamanyo" => 639144 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">T1 Spin-Echo sequences with selective fat suppression (SPIR) in the MRI before gadolinium i.v. injection (A), <span class="elsevierStyleSup">18</span>F-FDG PET/CT images (B, C and D) and Hematoxylin–Eosin staining (E). Images showed bilateral intraorbital lesions (A) which evidenced bilateral increased uptake of <span class="elsevierStyleSup">18</span>F-FDG in lacrimal glands (B), as well as supradiaphragmatic FDG-avid adenopathies (C and D). These findings are consistent with malignancy. Hematoxylin–Eosin staining of lacrimal gland (E) showed diffuse lymphomatous infiltration.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">About 8% of all extranodal lymphomas arise in the ocular adnexa, including the conjunctiva, the eyelids, the lacrimal gland, and orbital soft tissue. Mantle cell lymphoma usually arise in lymphatic nodes while extranodal involvement is very uncommon.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> We report a case of a 74-year-old female with history of rapidly growing tumor in the palpebral portion of the right lacrimal gland displacing the eyeball ventromedially. Craneal MRI (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) demonstrated two bilateral intraorbital solid expansive tumors with similar homogeneous radiographic appearance, located in the upper outer quadrant of the orbit in the region of the lacrimal gland. A staging <span class="elsevierStyleSup">18</span>F-FDG PET/CT demonstrated a moderately increased uptake in both lacrimal gland (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B) with measured SUVmax 6.7 and 5.5 in the right and left lacrimal gland respectively, as well as supradiaphragmatic FDG-avid adenopathies in cervical and axillary regions (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and D) up to 1.7<span class="elsevierStyleHsp" style=""></span>cm in greatest dimension and SUVmax values up to 6.6 (mediastinal mean SUV 1.5), corresponding to stage IV. Pathological study of lacrimal gland (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E) showed a diffuse lymphoid infiltration of small cell rounded nucleus, with CD20+/CD43+/CD5+ phenotype, cyclin D1-positive, and IGH-CCND1 translocation, consistent with mantle cell lymphoma with low proliferative index (Ki67<5%). Eight cycles of Rituximab-Cyclosporine-Vincristine-Prednisone (R-CVP) followed by Rituximab maintenance for 2 years were established.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-01-10" "fechaAceptado" => "2015-03-13" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martínez-Esteve A, García-Gómez FJ, Borrero-Martin JJ, Fajardo-Pico E, Borrego-Dorado I. <span class="elsevierStyleSup">18</span>F-FDG PET/TC en un caso de infiltración lacrimal bilateral por linfoma de células del manto. Rev Esp Med Nucl Imagen Mol. 2015. <span class="elsevierStyleInterRef" id="intr0005" href="doi:10.1016/j.remn.2015.03.006">http://dx.doi.org/10.1016/j.remn.2015.03.006</span></p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1887 "Ancho" => 3000 "Tamanyo" => 639144 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">T1 Spin-Echo sequences with selective fat suppression (SPIR) in the MRI before gadolinium i.v. injection (A), <span class="elsevierStyleSup">18</span>F-FDG PET/CT images (B, C and D) and Hematoxylin–Eosin staining (E). Images showed bilateral intraorbital lesions (A) which evidenced bilateral increased uptake of <span class="elsevierStyleSup">18</span>F-FDG in lacrimal glands (B), as well as supradiaphragmatic FDG-avid adenopathies (C and D). These findings are consistent with malignancy. Hematoxylin–Eosin staining of lacrimal gland (E) showed diffuse lymphomatous infiltration.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphoma of the ocular adnexa: a study of 353 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Ferry" 1 => "C.Y. Fung" 2 => "L. Zukerberg" 3 => "M.J. Lucarelli" 4 => "R.P. Hasserjian" 5 => "F.I. Preffer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2007" "paginaInicial" => "170" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3513636" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular adnexal lymphomas: five case presentations and a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.E. Coupland" 1 => "M. Hummel" 2 => "H. Stein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Suv Ophtalmol" "fecha" => "2002" "volumen" => "47" "paginaInicial" => "470" "paginaFinal" => "490" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003400000006/v1_201510310036/S2253808915000920/v1_201510310036/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003400000006/v1_201510310036/S2253808915000920/v1_201510310036/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808915000920?idApp=UINPBA00004N" ]
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