Increased Bone Marrow 18F-Choline Uptake in a Patient with Hepatocellular Carcinoma and Thalassemia Intermedia

Luca Filippi

doi:10.4274/mirt.galenos.2019.03064

Abstract

A 57-year-old male with history of thalassemia intermedia and hepatocellular carcinoma underwent a positron emission tomography/computed tomography (PET/CT) scan with 18F-choline before radioembolization procedure with 90Y-microspheres. The PET/CT scan with 18F-choline demonstrated highly increased tracer incorporation within a gross lesion in the hepatic dome coupled with diffuse activity in bone marrow, this latter aspect was probably due to the compensatory hematopoiesis stimulation induced by chronic hemolysis. This pattern of skeletal 18F-choline uptake should be considered as a peculiar PET/CT finding in thalassemic patients.

Highlights

A 57-year-old male with history of thalassemia intermedia and hepatocellular carcinoma underwent a positron emission tomography/computed tomography (PET/CT) scan with 18F-choline before radioembolization procedure with 90Y-microspheres
Iron overload due to the chronic hemolysis and periodic blood transfusion leads to severe complications, especially at cardiac and hepatic level
Since recent improvements in treatment of thalassemia have led to a significantly prolonged survival, HCC, most probable related to the frequent association of hepatitis C virusinfection and hemocromatosis in thalassemic patients, has emerged as a relatively new complication in long-term survivors [3]

Summary

Introduction

A 57-year-old male with history of thalassemia intermedia and hepatocellular carcinoma underwent a positron emission tomography/computed tomography (PET/CT) scan with 18F-choline before radioembolization procedure with 90Y-microspheres. Talasemi intermedia ve hepatosellüler karsinom tanılı bir hastada 90Y-mikrosfer ile radyoembolizasyon prosedürü öncesi 18F-kolin ile pozitron emisyon tomografisi/bilgisayarlı tomografi (PET/BT) taraması yapıldı. 18F-kolin ile PET/BT taraması karaciğer kubbesindeki büyük bir lezyon içerisinde artmış tracer tutulumu ve muhtemelen kronik hemoliz ile indüklenen kompansatuvar hematopoezise kemik iliğinde artmış aktivite gösterdi.

Results

Conclusion