Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

Focal Cardiac Uptake on FDG PET/CT in Two Paediatric Cases of Lymphoma

  • Mr Theo Kitsos, Department of Nuclear Medicine, The Children's Hospital, Westmead, Australia
  • Dr Kevin London, Department of Nuclear Medicine, The Children's Hospital, Westmead, Australia
  • Prof Robert Howman-Giles, Department of Nuclear Medicine, The Children's Hospital, Westmead, Australia

    • Cardiac involvement in lymphoma has been described with a wide frequency (8.7-36%) in adults. In the paediatric literature the incidence is rare and the overall outcome poor. Two cases of paediatric patients with lymphoma are described.
    Case 1: An 11-year-old female presented with a femoral bone mass for investigation of a suspected osteosarcoma. Biopsy revealed precursor B-cell lymphoblastic lymphoma (P-BLL) and not a primary bone tumour. F-18 FDG PET/CT scan demonstrated extensive areas of metabolically activity in the left proximal femur, bilateral pelvis, right scapula, multiple and extensive lymph nodes in the abdomen and kidneys. Two focal cardiac lesions were seen in the right atrial appendage and atrio-ventricular groove. These were confirmed on a diagnostic CT. After chemotherapy there has been resolution of the cardiac lesions and good metabolic response in the bone lesions with persisting residual activity in the right femoral lesion.
    Case 2: A 9 year old female presented with marked lymphadenopathy in the right axilla. Biopsy showed large cell anaplastic lymphoma. A PET/CT study revealed marked FDG avid disease in the right axilla, neck, mediastinum, ribs, abdominal para-aortic and bilateral iliac areas, right kidney and groin nodes. There was also a focus in the lower cardiac septum and pericardium. There was a complete metabolic response seen after chemotherapy.
    Conclusion: Cardiac involvement with lymphoma in paediatric patients is rare. Two cases are reported showing avid FDG uptake and excellent metabolic response with therapy.

    Conference Organiser - ICMS Pty Ltd