History Of non-Hodgkin Lymphoma Research Articles

Occurrence and Outcomes of Acute Cerebrovascular Events in Patients with Non-Hodgkin Lymphoma

Background Stroke or Cerebrovascular Accident (CVA) is one of the leading causes of mortality in the world whether it be ischemic or hemorrhagic 1,2. There has been an association of increased incidence of stroke in patients with cancer due to multiple factors 3. Regarding hematologic malignancies, there have been studies to assess the risk of developing stroke in patients with Hodgkin lymphoma (HL), however the information on non-Hodgkin lymphoma (NHL) is limited and not well understood4. We conducted a retrospective case-control study to assess the incidence, risks, and complications and length of stay of patients with current or prior history of NHL who developed an ischemic stroke. Methods This case-control study identified 29,632 patients older than 18 years, with or without CVA and with or without active or history of Non-Hodgkin Lymphoma (NHL) who were admitted to diverse private hospitals between 2018-2022. The patients were divided into two groups, one with current or prior NHL (n=10,699) and a control group of patients (n=18,933) with similar characteristics. Patients with active hemorrhagic stroke, pregnancy, malignancies other than NHL, prior hemorrhagic or ischemic stroke, infective endocarditis, atrial fibrillation, and acute coronary syndrome on admission were excluded. We compared patient's characteristics and the risk of developing a stroke based on the presence or absence of NHL as well as the factors that increased hospital mortality. Length of stay was evaluated as a secondary outcome. Bivariate statistical analysis was used to calculate the odds ratios using RStudio 4.2.2 and JMP Pro 16.0 for all data analysis. Results Of the group with NHL 46.39 % (n=4958) were female, and 53.61% (n=5729) were male, 42% were current or former smokers (n=4497), 27.49% (n=2941) had diabetes, 44.68% (n=4780) had hypertension; 3.34% (357) of them passed away. Of the control group 57.51 % (n=10876) were female, and 42.49% (n=8036) were male, 35% were current or former smokers (n=6763), 16.43% (n=3111) had diabetes, 28.89% (n=5469) had hypertension; 0.47% (n=88) of them passed away. The mean length of stay of patients with stroke was 7.99 days in the NHL group, and 5.99 days in the control group. Regarding the admissions due to stroke, there were 214 patients in the group with NHL, and in the control group where there were 113. Patients with NHL are more likely to have a CVA compared to the control group (OR 2.39 p<0.0001 CI 1.47~3.85) Patients who have NHL are more likely to die (OR=6.08 p<0.001) CI 4.77~7.74) compared to patients without NHL from all causes. Conclusion Patients with Non-Hodgkin lymphoma have an increased risk of developing a stroke compared to patients with similar characteristics but without NHL (or other malignancies). It was also noted that patients had an increased length of stay. Other variables and characteristics of patients that were identified to be more likely to have a CVA and statistically significant for this sample are already well-known risk factors for CVA including diabetes, hypertension, and cardiovascular disease. However, this study aimed to isolate those variables to identify the risk for stroke in this unique population. Our study limitation is the broad spectrum of NHL and possible confounders between the different variants of NHL. More studies are needed to investigate this. References Navi B, Reiner A, Kamel H, et al. Risk of Arterial Thromboembolism in Patients with Cancer. J Am Coll Cardiol. 2017 Aug, 70 (8) 926-938.Turner, M., Murchie, P., Derby, S. et al. Is stroke incidence increased in survivors of adult cancers? A systematic review and meta-analysis. J Cancer Surviv 16, 1414-1448 (2022). https://doi.org/10.1007/s11764-021-01122-7Dardiotis E, Aloizou AM, Markoula S, et al. Cancer-associated stroke: Pathophysiology, detection, and management (Review). Int J Oncol. 2019;54(3):779-796. doi:10.3892/ijo.2019.4669Wei Y, Yang Q, Qin Q, et al. Profiling of the Risk Factors and Designing of a Model to Identify Ischemic Stroke in Patients with Non-Hodgkin Lymphoma: A Multicenter Retrospective Study. Eur Neurol. 2020;83(1):41-48. doi:10.1159/000506046

Papillary Thyroid Cancer Presenting as Skull Metastasis

A 73-year-old man with a history of non-Hodgkin lymphoma in remission and well-controlled hypertension presented to his primary care physician’s office with a slow growing lump on his head. He denied any headaches and visual or auditory symptoms. The lump was initially thought to be a lipoma, and he was advised to follow up. Due to the COVID-19 pandemic, the patient did not follow up. He presented 6 months later with a progressive increase in the size of the lump. Physical examination was notable for an approximately 5 × 3-cm nontender mass with smooth surface, elastic consistency at the left parietal region without any associated skin changes.

Composite Classic Hodgkin Lymphoma and Follicular Lymphoma

Composite classic Hodgkin lymphoma and follicular lymphoma (CHLFL) is a rare and poorly characterized entity. Herein, we report the clinicopathologic features of 22 cases of CHLFL from 3 institutions and we assess 27 additional cases reported in the literature. In our cohort (n=22), patients with CHLFL had a median age of 61 years and an equal male to female incidence. Most cases (95%) arose de novo with the remaining patients having a history of non-Hodgkin lymphoma. CHLFL always involved lymph nodes (100%) and most cases (95%) revealed 2 distinct areas separately diagnostic for CHL and FL. The CHL component represented a variable proportion of the overall neoplasm (5% to 90%) and was either mixed cellularity (82%) or nodular sclerosis (18%) type. The Hodgkin/Reed-Sternberg cells expressed CD30 (100%), PAX5 (100%), CD15 (62%), BCL6 (47%), BCL2 (29%), and EBER (25%), in a polymorphous inflammatory background typical of CHL. The FL component was low-grade in 55%, grade 3A in 36%, and grade 3B in 9% of cases. All 3 cases investigated by cytogenetic methods for a clonal relationship between the CHL and FL components were clonally related. These clinicopathologic features of our cohort are similar to those of cases reported in the literature. The 5-year overall survival in combined patients with CHLFL (n=49) was 48%, comparable to CHL but worse than FL in the elderly. In summary, CHLFL is a rare entity that most often occurs in older adults, involves lymph nodes, and most commonly presents de novo. In the small number of cases assessed, the CHL and FL components are usually clonally related suggesting that the CHL and FL components may share a common progenitor B-cell, likely a mutated germinal center B-cell.

Introducing a very rare case of intra-pericardial thyroid tissue with blood supply from the aortic arch in a patient with renal cell carcinoma: A case report and review of the literature

Intra-pericardial heterotopic thyroid (IPHT) is an incidental finding during open-heart surgery. Although heterotopic thyroid has been reported in different parts of the body, only a few cases of intra-pericardium have been reported so far. In most articles, intracardiac, intrathoracic and heterotopic thymus cases are mistakenly included as IPTH cases A 57-year-old man with a history of non-Hodgkin lymphoma, who was treated 8 years ago and recovered, is now a candidate for surgery due to clear cell renal carcinoma in the left kidney with inferior vena cava (IVC) thrombus tumor that has spread into the right atrium. At the same time, he was operated on by two teams of urology and heart surgery. The patient’s kidney was removed, and then he was subjected to sternotomy by the heart surgery team to remove the thrombus tumor. After opening the pericardium inside the pericardial cavity, a pericardial mass measuring 1×2 ×3 cm, which was connected to the lower surface of the aortic arch by a 1 cm long stalk, was observed. It was resected and sent to pathology laboratory. The rest of the surgery to remove the thrombus tumor from inside the right atrium and IVC continued according to the procedure. The pathological report was benign thyroid tissue. Actual cases of IPTH are underreported, and due to the small number, it is not yet possible to comment on the prevalence of malignancy in it or its functional role; However any lesion or abnormal mass in the pericardial cavity should be respected and sent to pathology laboratory therefore by collecting information about these masses, in the future, decisions can be made and summarized.

Risk of Secondary Breast Cancer in Female Non-Hodgkin Lymphoma Survivors: 40 Years of Follow-Up Assessed by Treatment Modality

Survivors of non-Hodgkin lymphoma (NHL) are at increased risk of treatment associated secondary malignancies. We quantified the risk of developing a secondary breast cancer (SBC) in female NHL survivors with over 40 years of follow-up, and evaluated differences in risk by treatment modality.Standardized incidence ratios (SIR, observed-to-expected [O/E] ratio), which accounts for patient years at risk, and absolute excess risk of SBC were assessed in 65,123 female patients diagnosed with NHL as a first malignancy between 1975 and 2016 in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Only invasive disease was considered SBC, ductal carcinoma in situ was excluded. Follow up was available through 2016. SIRs were also evaluated for patients stratified by age at and latency from diagnosis.In all, 7,010 (10.8%) patients received radiotherapy alone (RT), 30,393 (46.7%) received chemotherapy alone (CT), and 7,845 (12.0%) received chemotherapy and radiation (CRT). In total, there were 1,480 female SBCs with NHL survivors having a lower incidence of SBC than the endemic rate (O/E 0.91, 95 % CI 0.87-0.96, P < 0.05. Patients treated with RT were at a higher risk of SBC than those who did not receive RT (O/E 1.02, 95% CI 0.93-1.12 vs O/E 0.87, 95% CI 0.82-0.93 respectively; P < 0.05). When stratified by treatment groups (No therapy, RT alone, CT alone, and CRT) there was a significantly higher risk of SBC in the CRT group than any other treatment group (O/E 1.18, 95% CI 1.03-1.34, P < 0.05). When patients were stratified by age at diagnosis, there was a significantly increased risk of SBC in patients who were diagnosed at age < 25 years irrespective of RT status with O/E ratios of 3.07 and 3.97 in the RT and no RT groups, respectively. However, there was no significant difference between these two treatment groups. This effect decreased with increasing age at diagnosis of NHL. The risk of developing SBC was significantly higher at > 10 years from NHL diagnosis (O/E 1.12) compared to < 10 years (O/E 0.82).This is the largest study to examine SBC risk in patients with NHL. These results demonstrate that survivors of NHL have a lower incidence of invasive breast cancer compared to the general population. Patients treated with RT did have an increased risk over those with no RT; however, this did not exceed endemic breast cancer rate. The use of CRT and time > 10 years from NHL diagnosis were associated with higher risk of developing an SBC. Importantly, women diagnosed with NHL < 25 yrs of age had a higher rate of SBCs regardless of RT use. These results may help inform breast cancer screening protocols for women with a history of NHL.

Idiopathic Multicentric Castleman Disease

Castleman Disease (CD) is a spectrum of heterogenous hematological diseases that share characteristic clinical, histopathological, and immunological features. We present a case of a 61-y female with history of non-Hodgkin Lymphoma and hypothyroidism presenting with fatigue, generalized weakness, nausea, and poor appetite. On admission, physical examination was unremarkable, and labs were notable for hyperkalemia, hyperuricemia and worsening renal function. Imaging showed lymphadenopathy in neck, mediastinum, and left axilla along with mediastinal and retroperitoneal lymphadenopathy. Initial work up of serum electrophoresis was suggestive of multiple myeloma however bone scan did not reveal any lytic lesions. As biopsy results were pending, patient developed worsening cytopenia’s and a repeat serum electrophoresis showed a M spike with IgG lambda against a polyclonal background. Bone marrow biopsy showed polytypic plasmacytosis that was negative for HHV 8 and lymph node biopsy also showed polytypic plasmacytosis. Further work confirmed the diagnosis of idiopathic multicentric Castleman disease and patient was treated with silutuximab and responded well.

2126 Endoscopic Ultrasound-Guided Splenic Mass Biopsy. an Accessible Technique for Differential Diagnosis of Lymphoma

INTRODUCTION: Traditional methods for splenic mass biopsy includesurgical or percutaneous technique, however there is an increased risk of hemorrhage, hematoma or cutaneous infection associated with these techniques. In addition, these techniques do not allow us to evaluate adjacent organs. Endoscopic ultrasound (EUS) provides a novel method for splenic mass biopsy and should be considered for such procedures. Our case highlights technique for a successful and safely done EUS guided splenic mass biopsy. CASE DESCRIPTION/METHODS: Case: 68-year-old female with history of non-Hodgkin lymphoma in remission, stage IIIbsquamous cell carcinoma of anus treated with chemoradiation and on surveillance referred to GI after a surveillance CT abdomen/pelvis revealed spleen enlargement with hypodensities. This was followed by PET/CT with increased uptake on anal region, spleen, stomach and supraclavicular node. Endoscopy with EUSwas performed. Biopsies were obtained from stomach and duodenum. EUS imaging showed splenic lesion. Fine Needle Biopsy was performed with 22-gauge needle with a slow pool technique. 4 needle passes were made into the mass. Specimen was sent for pathology and flow cytometry. Patient tolerated procedure without complications. Biopsy report showed evidence of B cell lymphoma on all samples with diagnosis of relapsed B cell Non-Hodgkin lymphoma. DISCUSSION: EUS can provide a feasible and safer technique to obtain splenic mass biopsies. This technique utilizes the proximity of gastrointestinal tract and therefore a readily accessible path to obtain splenic biopsies. Endoscopic ultrasound can also provide a safe way to evaluate adjacent organs during the work up of disease extent involvement, all in one minimally invasive procedure,reducing the amount of risks and complications associated with traditional biopsy techniques.

Bifocal Metanephric Adenoma in a Patient with Non-hodgkin Lymphoma

Metanephric adenoma (MA) is a rare benign renal tumor. Radiology does not clearly differentiate between this benign lesion and renal carcinoma accurately. We report the case of a woman with history of non-Hodgkin lymphoma. CT scan showed nodules in one kidney, and radical nephrectomy was performed under the appearance of hypernephroma. Two lesions were identified, and the histopathological diagnosis was MA. No other MA has been reported in patients with non-Hodgkin lymphoma. The correct diagnosis of this tumor prevents radical nephrectomy. In the current report we describe two foci of tumor, and being MA usually solitary, its benign characteristics might be more challenging.

Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008.

In the current study, the authors attempted to describe the incidence, most common sites, and mortality of second primary malignancies among survivors of common cancers. The authors identified patients aged ≥18 years who were diagnosed with a primary malignancy from the 10 most common cancer sites (prostate, breast, lung, colon, rectum, bladder, uterus, kidney, melanoma, and non-Hodgkin lymphoma) between 1992 and 2008 from Surveillance, Epidemiology, and End Results data. Factors associated with the incidence of second primary malignancies were explored using bivariable and multivariable models, and mortality attributable to first and second primary malignancies was examined. A cohort of 2,116,163 patients was identified, 170,865 of whom (8.1%) developed a second primary malignancy. Survivors of bladder cancer had the highest risk of developing a second cancer. In a multivariable model controlling for age, race, tumor grade, stage of disease, marital status, educational level, and income, a history of non-Hodgkin lymphoma (hazard ratios of 2.70 and 2.88, respectively, for men and women) and bladder cancer (hazard ratios of 1.88 and 1.66, respectively, for men and women) predicted the highest risk of developing a second cancer. For patients with 2 incident cancers, 13% died of their initial cancer, but greater than one-half (55%) died of their second primary malignancy. Lung cancer was the cause of death in 12% of patients with 2 incident cancers. Nearly 1 in 12 patients diagnosed with a common cancer developed a second malignancy, the most common of which was lung cancer. Greater than one-half of patients with 2 incident cancers died of their secondary malignancy. The findings from the current study may inform care strategies among cancer survivors. Cancer 2016;122:3075-3086. © 2016 American Cancer Society.

Multiple myeloma and family history of lymphohaematopoietic cancers: Results from the International Multiple Myeloma Consortium.

Family clusters of multiple myeloma (MM) suggest disease heritability. Nevertheless, patterns of inheritance and the importance of genetic versus environmental risk factors in MM aetiology remain unclear. We pooled data from eleven case-control studies from the International Multiple Myeloma Consortium to characterize the association of MM risk with having a first-degree relative with a history of a lympho-haematapoietic cancer. Unconditional logistic regression models, adjusted for study, sex, age and education level, were used to estimate associations between MM risk and having a first-degree relative with a history of non-Hodgkin lymphoma, Hodgkin lymphoma, leukaemia or MM. Sex, African American race/ethnicity and age were explored as effect modifiers. A total of 2843 cases and 11470 controls were included. MM risk was elevated in association with having a first-degree relative with any lympho-haematapoietic cancer (Odds Ratio (OR)=1·29, 95% Confidence Interval (CI): 1·08-1·55). The association was particularly strong for having a first-degree relative with MM (OR=1·90, 95% CI: 1·26-2·87), especially among men (OR=4·13, 95% CI: 2·17-7·85) and African Americans (OR=5·52, 95% CI: 1·87-16·27).These results support the hypothesis that genetic inheritance plays a role in MM aetiology. Future studies are warranted to characterize interactions of genetic markers with environmental exposures.

Effect of Non-Hodgkin Lymphoma on Survival in Patients With Malignant Fibrous Histiocytoma, Kaposi Sarcoma, and Sebaceous Carcinoma: A SEER Population-Based Study.

To quantify the behavior of dermatofibrosarcoma protuberans (DFSP), malignant fibrous histiocytoma (MFH), Kaposi sarcoma (KS), and sebaceous carcinoma (SC) in patients with a history of non-Hodgkin lymphoma (NHL). Subjects with a diagnosis of DFSP, MFH, KS, or SC between 1990 and 2006 were identified in the Surveillance, Epidemiology, and End Results Program database. For each skin cancer type, the standardized mortality ratio (SMR) for death due to any cause and death due to skin cancer was estimated. From 1990 through 2006, 25,357 skin cancers were identified: 4,192 DFSP, 6,412 MFH, 10,543 KS, and 4,222 SC. For patients with a history of non-CLL NHL, SMRs for death due to any cause were 1.45 (95% confidence interval [CI], 1.03-2.04; p = 0.04) for MFH, 2.90 (95% CI, 2.50-3.36; p < 0.001) for KS, and 3.25 (95% CI, 1.84-5.75; p < 0.001) for SC and SMRs for death due to skin cancer were 0.55 (95% CI, 0.23-1.31; p = 0.18) for MFH, 2.93 (95% CI, 2.49-3.43; p < 0.001) for KS, and 4.07 (95% CI, 1.28-12.94; p < 0.001) for SC. Among patients with KS and SC, patients with a history of non-CLL NHL have a greater risk of overall and cause-specific death than expected.

HIV Testing in Patients With Cancer at the Initiation of Therapy at a Large US Comprehensive Cancer Center.

To determine the rates of HIV testing and infection among patients with cancer at initiation of systemic cancer therapy. We conducted a retrospective cohort study of adults with cancer who registered at a comprehensive cancer center from January 2004 through April 2011 and received systemic cancer therapy. We determined rates of HIV-1/2 and/or Western blot testing and HIV positivity at initiation of systemic cancer therapy. Multivariable logistic regression was used to determine predictors of HIV testing. Of 18,874 patients with cancer who received systemic cancer therapy during the study period, 3,514 (18.6%) were tested for HIV at initiation of cancer therapy. The prevalence of positive HIV test results was 1.2% (41 of 3,514), and the prevalence of newly diagnosed HIV was 0.3% (12 of 3,514). The HIV testing rate was lower in black than in white patients (13.7% v 19.2%), but the prevalence of positive test results was higher in black patients (4.5%) than in any other racial/ethnic group. Among patients with AIDS-defining cancers (eg, non-Hodgkin lymphoma and cervical cancer), predictors of HIV testing were history of non-Hodgkin lymphoma, younger age, and registration after 2006. Among patients with non-AIDS-defining cancers, predictors of HIV testing were younger age, registration after 2006, male sex, history of illicit drug use or sexually transmitted disease, having a hematologic malignancy, and black race. The prevalence of HIV infection among patients with cancer was 1.2%, higher than the 0.1% prevalence threshold above which national guidelines recommend routine opt-out testing; however, the overall HIV testing rate was low.

Pseudoachalasia in a patient with a history of non-Hodgkin lymphoma

Pseudoachalasia in a patient with a history of non-Hodgkin lymphoma

Acetaminophen and the pain management in cesarean post-operatory

Effective post-caesarean pain relief is important, once this promotes a better and faster recovery and can diminish the hospital expenses. Paracetamol (acetaminophen) is the most commonly used drug to treat fever or pain, both as an over the counter drug as well as in the hospital setting. Many works demonstrated the efficacy of Paracetamol as analgesic in pregnancy: Paracetamol infusion and the diclofenac intramuscular injection have analgesic efficacy similar to the intravenous pethidine. In a pregnant, 34 years, history of Non-Hodgkin Lymphoma in 5 years remission and with Tail Syndrome Equine manifestations the analgesia was maintained with Paracetamol, magnesium Dipyrone and, intercalary with Paracetamol, tramadol; a case of a nulliparous, 39 weeks, with arteriovenous malformations and whose postoperative analgesia was assured with Paracetamol by intravenous three peridural bolus of ropivacaine and morphine.However, acetaminophen is associated with risks for women and her baby: neurodevelopmental and behavioral disorders; reduced gross motor skills, delay in walking, increased activity, reduced communication skills, and attention-seeking or aggressive behavior; Recent studies also suggest that acetaminophen is a hormone disrupter. Future studies comparing the usage of Paracetamol and other possible combinations are necessary, provided that they have significant statistical samples and standard tools accepted internationally to measure pain levels.

Lumbosacral Plexopathy: Initial and Infrequent Manifestation of Relapsed Non- Hodgkin's Lymphoma

Lymphoma is a blood tumor, with an incidence of 11 cases per 100,000 inhabitants being 25% Hodgkin lymphoma (HL) and 75% non-Hodgkin's lymphoma (NHL). Peripheral neurological involvement is very uncommon (1-5% of lymphomas) and the most are due to NHL. The mechanisms described in peripheral neurological involvement are extrinsic tumor compression, direct infiltration, chemoradiotherapy, infection or paraneoplastic autoimmunity. We report the case of a patient of 69 years with a history of NHL in complete remission with progressive symptoms of pain, weakness, paresthesia and hypoesthesia in right lower limb. After complementary tests, infiltrative lumbosacral plexopathy as the initial manifestation of relapse NHL was diagnosed. For this reason the patient underwent hematological and rehabilitation treatment, without clinical improvement from the functional point of view. We highlight the case because of the uncommon of their presentation and the importance of diagnosis as to the prognosis for recovery.

TCTAP C-048 PCI in Acute Myocardial Infarction Evolving in Cardiogenic Shock Due to Uncommon Cause

### Patient initials or identifier number M.T. ### Relevant clinical history and physical exam A 38-years-old man, with a history of Non-Hodgkin lymphoma treated with mediastinal irradiation 15 years before and mild hypercholesterolemia, was urgently admitted to our hospital with an acute

Transient liver function abnormality following treatment with rabbit antithymocyte globulin for nonmyeloablative hematopoetic stem cell transplant: Two case reports

Rabbit antithymocyte globulin (rATG) is increasingly used in nonmyeloablative hematopoetic stem cell transplant (HSCT). Elevated liver function tests (LFTs) have been reported for antithymocyte globulin in the treatment of aplastic anemia, but not when used in a conditioning regimen for HSCT. We describe two cases of patients receiving a conditioning regimen for HSCT containing rATG who developed a transient, severe transaminase elevation. In the first case, a 66-year-old woman with a history of acute myeloid leukemia received the first dose of rATG and the patient's transaminases were found to be extremely elevated within a few hours. The aspartate transaminase (AST) peaked at 1286 U/L and alanine transaminase (ALT) peaked at 991 U/L and both resolved within a week. In the second case, a 72-year-old woman with a history of non-Hodgkin lymphoma received the first dose of rATG and the AST and ALT were found to be 1212 U/L and 689 U/L, respectively, 1 h after finishing the infusion. Like the previous case, the transaminase elevation resolved within a week. LFT abnormalities induced by rATG during conditioning therapy for HSCT may be transient and have a rapid onset after the first dose, but quickly subside without any complications or sequelae. It is important to follow the LFTs closely, as well as monitor for any signs and symptoms of acute liver failure.

Bilateral trigeminal nerve recurrence of non-hodgkin lymphoma revealed with FDG PET/CT

Bilateral trigeminal nerve involvement is a rare presentation of Non-Hodgkin lymphoma (NHL). The trigeminal nerve, also called the fifth cranial nerve, leaves the brainstem and exits the base of the skull to supply sensation to the face. In this case, we present a case of a 63-year-old male patient with a history of NHL and a more recent history of headache and trigeminal neuralgia. The patient underwent PET/CT demonstrating bilateral increased FDG uptake in trigeminal nerves.

Iatrogenic pulmonary nodule in a heart transplant recipient.

A 58-year-old female with a history of non-Hodgkin lymphoma and end-stage nonischemic cardiomyopathy from Adriamycin toxicity underwent orthotic heart transplantation during June 2013. She developed shortness of breath in September 2013 and was suspected to have invasive pulmonary aspergillosis. A flexible bronchoscopy (FB) with a transbronchial biopsy (TBBx) was performed. She was found to have a focal lung nodule in the same location at the site of the TBBx on day 13 after the FB. Spontaneous resolution of the nodule was confirmed on the computed tomography (CT) scan of chest performed at 3 months. We believe that this nodule was as a consequence of the TBBx. Formation of a peripheral pulmonary nodule (PPN) following a TBBx is occasionally encountered among the recipients of the lung transplantation. To our knowledge, this is the first case of TBBx producing a pulmonary nodule in a heart transplant recipient. Physicians caring for the patients with heart transplantation should be cognizant of the iatrogenic nature of such nodule to avoid unnecessary diagnostic work-up.

Abdominal Aortic Aneurysm With Bony Erosion Mimicking Recurrent Non–Hodgkin Lymphoma on FDG PET/CT

An 80-year-old man with a history of non-Hodgkin lymphoma in complete remission after chemotherapy in 2009 presented with lumbar pain. MRI demonstrated anterior L4 bony erosions. FDG PET/CT revealed the large retroperitoneal mass with central photopenia and a mildly hypermetabolic rim. Ultrasound revealed a dilated aorta with atherosclerotic plaque and eccentric mural thrombus. A newly developed mass-like lesion in a patient with history of lymphoma could be mistaken for lymphoma recurrence on FDG PET/CT.