Peritoneal Super Scan on 18F-FDG PET/CT in two patients with Lymphoma

Document Type: Case report

Authors

Department of Nuclear Medicine, Mohammed V Military Teaching Hospital, Mohammed V University of Rabat, Morocco

Abstract

Peritoneal lymphomatosis is an extremely rare presentation of lymphoma. Due to its relative low frequency, it receives much less attention than peritoneal carcinomatosis. The challenge is to differentiate between lymphomatosis and carcinomatosis, as well as peritoneal tuberculosis or other pathologic entities within the peritoneal cavity based essentially on radiologic features.
18F-FDG PET/CT is the main imaging modality for staging and monitoring response to treatment in lymphoma. Peritoneal lymphomatosis is most often associated to aggressive histological subtypes of high-grade lymphoma which are reputed high FDG uptake.
  We report two cases of Burkitt’s lymphoma and diffuse large B cell lymphoma (DLBCL), with intense FDG uptake involving the entire peritoneum and decreased FDG activity of the rest of the body including brain and kidneys, giving it an appearance of “peritoneal super scan”, follow up FDG PET/CT showed the disappearance of the peritoneal lymphomatosis and the reappearance of cerebral and urinary activity synonym of complete metabolic response.

Keywords


  1. Park EK, Lee SR, Kim YC, Oh SY, Choe JG. Peritoneal Lymphomatosis Imaged by F-18 FDG PET/CT. Nucl Med Mol Imaging. 2010; 44:159-160. 
  2. Yapar AF, Reyhan M. 18F-FDG uptake in diffuse peritoneal lymphomatosis. Clin Nucl Med. 2012; 37:176–177.
  3. Cunningham N, Ffrench-Constant S, Planche K, Gillmore R. Peritoneal lymphomatosis: a rare presentation of follicular lymphoma mimicking peritoneal carcinomatosis. Case Reports. 2015; 2015:bcr2014207136.
  4. Lu SJ, Sinha AK: Peritoneal lymphomatosis shown on positron emission tomography/ computed tomography scanning. Br J Haematol 2011; 153(3):290.
  5. Uslu L, Sen F, Sager S, Halaç M. Extensive peritoneal and pleural lymphomatosis in a patient with Burkitt lymphoma revealed with 18F-FDG PET/CT. Nuklearmedizin. 2013; 52:56–57.
  6. Van Rheenen RW, Bongaerts AH, Glaudemans AW. Peritoneal lymphomatosis found on 18F-FDG PET/CT. Eur J Haematol. 2012; 89:503-504.
  7. Wong S, Sanchez TR, Swischuk LE, Huang FS. Diffuse peritoneal lymphomatosis: atypical presentation of Burkitt lymphoma. Pediatr Radiol. 2009; 39:274-276.
  8. Roy SG, Parida GK, Tripathy S, Singhal A, Shamim SA, Tripathi M. Peritoneal super scan on 18F-FDG PET-CT in a patient of burkitt's lymphoma. Indian J Nucl Med. 2017; 32:155-6.
  9. Kim DW, Kim CG, Park SA, Jung SA, Yang SH. Metabolic super scan in F-FDG PET/CT imaging. J Korean Med Sci. 2010; 25:1256-7.
  10. Su HY, Liu RS, Liao SQ, Wang SJ.  F-18 FDG PET superscan. Clin Nucl Med 2006; 31: 28-9.
  11. Basu S, Nair N. Unusually elevated liver radioactivity on F-18 FDG PET in Hodgkin’s disease: hepatic ‘superscan’. Clin Nucl Med. 2004; 29:626-8.