Imaging characteristics of ¹⁸F-FDG PET/CT in patients with newly diagnosed angio-immunoblastic T cell lymphoma

Objectives A relative paucity of data exists in the literature regarding the utility of ¹⁸F-FDG PET/CT in the clinical management of patients with angio-immunoblastic T cell lymphoma (AITL). Our goal is to explore the PET/CT imaging characteristics and the potential role in AITL.

Methods Eight Patients with newly diagnosed AITL underwent FDG PET/ CT between Aug 2010 and Dec 2014 were retrospectively reviewed. The maximum standardized uptake value (SUVmax) of the hottest tumor in each patient was recorded. Patients were 4 female and 4 male (age 35-71 years). All lesions were proven by pathology or follow-up.

Results PET/CT showed increased FDG uptake in all cases, with SUVmax ranged from 7.1 to 11.7. Lesions involvement in order of frequency was multiple lymph nodes (100%, 8/8), spleen (100%, 8/8), bone marrow (62.5%, 5/8), nasopharynx (37.5%, 3/8) and thyroid (12.5%, 1/8). Spleen of all patients were enlarged and FDG avid(SUVmax, 2.3～6.4). Bone marrow involvement pattern were focal (20%, 1/5) and diffused type (80%, 4/5). One patient was with increased FDG activity in left thyroid lobe and without any corresponding CT abnormality, posttreatment PET/CT proved the involvement of thyroid. Based on PET/CT results, all patients were staged Phase Ⅳ. PET/CT findings altered the stage and treatment strategy in 2 cases (25%, 2/8).

Conclusions AITL, as a type of aggressive lymphoma, manifests markedly FDG uptake on PET/CT. Multiple lymph nodes, spleen and bone marrow are most frequently involved. It is recommended that patients with this special type perform ¹⁸F-FDG PET/CT pretreatment for clinical management.

Research Support This work is support, in part, by the Seeding Grant for Medicine and Engineering Sciences of Peking University(2014-ME-13) and by the Foundation for the Returned Overseas Chinese Scholars of Peking University First Hospital