18F‐fluorodeoxyglucose positron emission tomography/computed tomography in the evaluation of early response in a primary hepatic lymphoma

Abstract

We present a case of a 58-year-old man with a diagnosis of primary hepatic lymphoma, classified as diffuse large B-cell lymphoma. The patient also suffered from hepatitis C virus (HCV)-related chronic hepatitis. He underwent a total body F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) scan, which revealed two hypodense CT lesions in the left lobe and in the fifth segment of the liver, both showing intense F-FDG uptake (top figures); no other pathological uptake was observed. Thereafter, the patient underwent chemotherapy with six courses of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). After two courses of therapy the F-FDG PET/CT scan was repeated; while persistence of liver disease was suggested by CT, no F-FDG uptake was evident (bottom figures). At the end of the treatment one hypodense lesion was still present on the CT scan, while the PET scan remained negative. After 25 months the patient is still alive and in complete remission. Primary hepatic non-Hodgkin lymphoma (NHL) is very rare, representing <0AE016% of all NHL. It has often been associated with HCV infection. In the case presented here,FFDG PET/CT scanning was very useful in evaluating the early response to treatment and in confirming the absence of active disease at the end of treatment.