Abstract
Sjögren syndrome (SS) is an autoimmune disease with exocrine glands dysfunction and multiorgan involvement. It is associated with increased risk of lymphoproliferative disorders, especially B-cell marginal zone lymphoma. While the role of F-18 Fluorodeoxyglucose position emission tomography/computed tomography (F-18 FDG PET/CT) for evaluation of lymphoma has been established, its use in patients with a chronic history of SS to evaluate for possible lymphoproliferative disorders or multiorgan involvement is limited. We present a case of chronic SS in which F-18 FDG PET/CT demonstrated FDG avid intraparotid and cervical lymph nodes pathologically proven to be mucosa-associated lymphoid tissue lymphoma. In addition, the patient had bibasilar cystic changes consistent with lymphocytic interstitial pneumonia.
Highlights
F-18 Fluorodeoxyglucose position emission tomography/computed tomography (F-18 FDG PET/CT) plays an important role in the evaluation of lymphoma
The patient is currently receiving hydroxychloroquine therapy for Sjögren syndrome (SS) and monitoring of lymphoma, follow-up F-18 FDG PET/CT was recommended per the oncologist
Patients who developed lymphoma had an even higher SUV max than patients without lymphoma. They concluded F-18 FDG PET/CT could be useful for optimizing diagnosis, post-therapy evaluation of lymphoma, and multiorgan involvement in patients with SS
Summary
F-18 Fluorodeoxyglucose position emission tomography/computed tomography (F-18 FDG PET/CT) plays an important role in the evaluation of lymphoma. Patients with chronic Sjögren syndrome (SS) are at risk of lymphoproliferative disorders, B-cell marginal zone lymphoma. There are limited publications on the role of F-18 FDG PET/CT in evaluating these patients for possible development of lymphoma or multiorgan involvement with only a few cases reported. We present a patient with a 15-year history of SS in which F-18 FDG PET/CT demonstrated hypermetabolic intraparotid and cervical lymph nodes pathologically proven to be lymphoma. There were bibasilar cystic changes in the lungs consistent with lymphocytic interstitial pneumonia (LIP)
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