Primary Epstein-Barr virus infection diffusing F18-fluorodeoxyglucose-positron emission tomography/computed tomography response monitoring of Hodgkin's disease: a case report.

Abstract

INTRODUCTION:

Hodgkin's disease is highly curable by radiotherapy and/or chemotherapy, but refractory disease or early relapses are rarely cured by conventional salvage therapy.

CASE PRESENTATION:

We report a case of a 20-year-old Caucasian man, with a biopsy-proven intrapulmonary relapse of Hodgkin's disease, for whom salvage chemotherapy was administered. During salvage chemotherapy intense increased F18-fluorodeoxyglucose uptake was noticed in multiple lymph nodes and diffuse increased splenic uptake, suggesting chemotherapy-refractory disease. However, additional information obtained from the patient revealed he recently had met his first girlfriend. An asymptomatic primary Epstein-Barr virus infection was considered proven.

CONCLUSIONS:

Interim F18-fluorodeoxyglucose-positron emission tomography/computed tomography is a strong prognostic factor for advanced Hodgkin's and may better identify those patients needing intensified chemotherapy. Related to the nonspecificity of F18-fluorodeoxyglucose, clinical awareness of the potential interference of intercurrent asymptomatic viral infections with treatment and remission status monitoring continues to be important in the interpretation of equivocal medical imaging results.

• Authors: Hans Balink, Mels Hoogendoorn
• Journal: Journal of medical case reports (J Med Case Rep) Vol. 8 Pg. 212 (Jun 20 2014) ISSN: 1752-1947 [Electronic] England
• PMID: 24950966 (Publication Type: Case Reports, Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Asymptomatic Infections
• Epstein-Barr Virus Infections (complications, diagnostic imaging)
• Fluorodeoxyglucose F18
• Hodgkin Disease (complications, diagnostic imaging)
• Humans
• Lung Neoplasms (complications, diagnostic imaging)
• Lymph Nodes (diagnostic imaging)
• Male
• Multimodal Imaging
• Neoplasm Recurrence, Local (complications, diagnostic imaging)
• Positron-Emission Tomography
• Radiopharmaceuticals
• Spleen (diagnostic imaging)
• Tomography, X-Ray Computed
• Young Adult