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18F-FDG PET/CT “superscan” in a patient with immunoblastic lymphoma
18F-FDG PET/TC “superscan” en paciente con linfoma inmunoblástico
Irene Acevedo-Báñez, Álvaro De-Bonilla-Damiá
, Rosa Fernández-López
Corresponding author
Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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He underwent two lines of chemotherapy and a subsequent splenectomy due to poor initial evolution. Three months after treatment, the patient experienced worsening of symptoms and a new PET/CT was requested on suspicion of progression.</p><p id="par0010" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT study showed a large number of supra and infradiaphragmatic lymph nodes and an intense increase in uptake in bone marrow (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), similar to the “superscan” pattern described in bone scintigraphy with <span class="elsevierStyleSup">99m</span>Tc-MDP, with no physiological uptake in kidney and brain parenchyma. Thus, progression of disease with bone marrow infiltration was histologically confirmed and a new line of treatment was established.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The “superscan” scintigraphy image is described as a striking image. It is characterized by symmetrical increase in bone uptake and lack of visualization of renal parenchyma. Similar features are described in studies with <span class="elsevierStyleSup">18</span>F-FDG PET as metabolic superscan.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a> This striking pattern has been reported in poorly differentiated renal carcinoma, gastric carcinoma, squamous lung carcinoma, small cell lung and kidney PNET, which are usually associated with poor prognosis. Moreover, a similar pattern has been observed with other radiopharmaceuticals as <span class="elsevierStyleSup">123</span>I-Metaiodobenzylguanidine in patients with neuroblastoma. Diffuse bone marrow uptake has been also reported in other hematologic malignances like multiple myeloma, lymphoma and lymphoblastic leukemia.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Acevedo-Báñez I, De-Bonilla-Damiá Á, Fernández-López R. <span class="elsevierStyleSup">18</span>F-FDG PET/TC “superscan” en paciente con linfoma inmunoblástico. Rev Esp Med Nucl Imagen Mol. 2019;38:252–253.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">All authors concur with the submission. This material has not been previously published and is not under consideration for publication elsewhere.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1012 "Ancho" => 1400 "Tamanyo" => 124419 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">18</span>F-FDG PET/CT study shows an intense and symmetrical uptake of bone marrow that produces an absence of physiological uptake in renal and brain parenchyma, whereas low uptake is observed in soft tissues, liver, spleen and also in supra and infra-diaphragmatic pathological lymph nodes.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Superscan-like hypermetabolic lesions on delayed FDG PET/CT imaging in a patient with lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. 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Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RLU.0000000000000785" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2015" "volumen" => "40" "paginaInicial" => "567" "paginaFinal" => "568" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26018718" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000003800000004/v1_201907020628/S2253808918300363/v1_201907020628/en/main.assets" "Apartado" => array:4 [ "identificador" => "47121" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000003800000004/v1_201907020628/S2253808918300363/v1_201907020628/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808918300363?idApp=UINPBA00004N" ]
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