Published in:
01-06-2015 | Interesting Image
Assessment of Therapy Response by 18F-FDG PET/CT for a Patient with Cutaneous and Subcutaneous Mycobacterium Infection and Coexisting Lymphoma
Published in: Nuclear Medicine and Molecular Imaging | Issue 2/2015
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In follow-up FDG PET/CT scans for our patient (A1, B1, C1: PET maximum intensity projection images; A2, B2, C2: corresponding axial PET/CT fusion images), most of the disseminated FDG-avid Mycobacterium abscessus infection resolved over time (short arrows). A biopsy confirmed a left posterior pleural lymphoma lesion (long arrows) and first demonstrated increased FDG avidity when chemotherapy for lymphoma was held off (SUVmax 14.8 on Fig. 1B1, B2; compared to SUV 8.3 on earlier PET/CT of Fig. 1A1, A2), then showed slightly decreased FDG avidity with resumed lenalidomide chemotherapy (SUVmax 10.0 on Fig. 1C1, C2).
Fig. 1
A 62-year-old male with marginal zone lymphoma who was on chemotherapy. After two cycles of chemotherapy, the patient developed innumerable cutaneous and subcutaneous nodules all over his body, with symptoms of fever (<39 °C) and a general feeling of illness. Biopsy and blood culture confirmed a Mycobacterium abscessus infection. After discussion at a multidisciplinary tumor board meeting, chemotherapy for lymphoma was temporarily stopped, and the patient was treated with a four-drug regime (amikacin, clarithromycin, cefoxitin and tigecycline) for the Mycobacterium abscessus infection
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