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- Title
Does Functional Imaging Distinguish Nodular Lymphocyte-Predominant Hodgkin Lymphoma From T-Cell/Histiocyte-Rich Large B-Cell Lymphoma?
- Authors
Barber, Nicholas A.; Loberiza, Jr., Fausto R.; Perry, Anamarija M.; Bast, Martin; Holdeman, Karen P.; Esfahane, Aliriza B.; Weisenburger, Dennis D.; Vose, Julie; Bierman, Philip; Armitage, James O.; Gregory Bociek, R.
- Abstract
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and T-cell/histiocyte-rich large B-cell lymphoma (THR-LBCL) share histologic features but require different therapies. We report clinical and functional imaging characteristics of twelve patients with either NLPHL or THR-LBCL. Earlier stage disease and less avid PET/CT findings were more characteristic of NLPHL and may influence patient management when histology alone makes distinguishing NLPHL from THR-LBCL difficult. Background: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is often associated with concurrent or subsequent development of T-cell/histiocyte-rich large B-cell lymphoma (THR-LBCL). Distinguishing the two is important because their therapies are different. Functional imaging with PET/CT is used to stage both Hodgkin and non-Hodgkin lymphomas. Aggressive lymphomas are usually more PET avid than the indolent subtypes. Therefore, it is possible that PET/CT may help distinguish NLPHL from THR-LBCL. Patients and Methods: Herein, we retrospectively describe the clinical and PET/CT findings of 12 patients with NLPHL or THR-LBCL seen from 2004-2010. Results and Conclusions: Six patients each were identified and the average SUVmax was 6.9 (range, 5.7-7.3) in NLPHL and 16.6 (range, 4-29) in THR-LBCL (p = 0.055). Bone and extranodal involvement was found in one patient with NLPHL compared to four patients with THR-LBCL. This patient failed to respond to ABVD and was subsequently found to have THR-LBCL. We suggest that patients with NLPHL and THR-LBCL have different clinical and PET/CT characteristics. NLPHL patients had lower SUVmax on PET/CT compared to those with THR-LBCL. The presence of bone or extranodal involvement is more common in patients with THR-LBCL. Patients with NLPHL and an uncharacteristically higher SUVmax on PET/CT, or those with bone or extranodal involvement, should alert the clinician to consider the presence of THR-LBCL
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2013, Vol 13, Issue 4, p392
- ISSN
2152-2650
- Publication type
Article
- DOI
10.1016/j.clml.2013.03.004