Diffuse large B cell lymphoma (DLBCL) is the most common histological subtype of Non-Hodgkin's lymphoma. As treatments continues to evolve, so do imaging strategies, and positron emission tomography (PET) has emerged as the most important imaging tool to guide oncologists in the diagnosis, staging, response assessment, relapse/recurrence detection,and therapeutic decision making of DLBCL. Other imaging modalities including magnetic resonance imaging (MRI), computed tomography (CT), ultrasound, and conventional radiography are also used in the evaluation of lymphoma. MRI is useful for nervous system and musculoskeletal system involvement and is emerging as a radiation free alternative to PET/CT. This article provides a comprehensive review of both the functional and morphological imaging modalities, available in the management of DLBCL.
B-Lymphocytes* ; Decision Making ; Diagnosis ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Magnetic Resonance Imaging ; Musculoskeletal System ; Nervous System ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Radiography ; Ultrasonography

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma that most commonly involves the central nervous system and skin. To our knowledge, no state-of-the art imaging findings have been reported for hepatic IVLBCL in the English literature. We report the first case of hepatic involvement of IVLBCL along with a literature review.
Antigens, CD20/metabolism ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Humans ; Liver Neoplasms/drug therapy/*pathology/radiography ; Lymphoma, Large B-Cell, Diffuse/drug therapy/*pathology/radiography ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Remission Induction ; Rituximab/administration & dosage ; Tomography, X-Ray Computed

A 39-year-old man infected with human immunodeficiency virus (HIV) was admitted to our hospital because of sudden onset of chest pain. Chest radiography revealed pneumothorax of the right lung. Computed tomographic scans disclosed a 5.8-cm-sized emphysematous bulla in the right middle lobe of the lung. Histologically, the wedge-resected lung showed medium to large atypical cells within the bullous cavity of the Pneumocystis jirovecii pneumonia, without solid mass formation. These atypical cells were confirmed to be large B-cell lymphoma, Epstein-Barr virus-positive and human herpesvirus 8-negative. Therefore, this case was not diagnosed as primary effusion lymphoma, but effusion-based lymphoma arising in an emphysematous cavity of an HIV-infected patient. This type of effusion-based lymphoma has never been reported, and, although rare, it should be noted in order to clinically diagnose this lymphoma.
Adult ; Chest Pain ; Herpesvirus 4, Human ; Herpesvirus 8, Human ; HIV* ; Humans* ; Lung ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Primary Effusion ; Pneumocystis jirovecii ; Pneumonia ; Pneumothorax ; Radiography ; Thorax

The radiologic findings of a single nodule from Pneumocystis jirovecii pneumonia (PJP) have been rarely reported. We described a case of granulomatous PJP manifesting as a solitary pulmonary nodule with a halo sign in a 69-year-old woman with diffuse large B cell lymphoma during chemotherapy. The radiologic appearance of the patient suggested an infectious lesion such as angioinvasive pulmonary aspergillosis or lymphoma involvement of the lung; however, clinical manifestations were not compatible with the diseases. The nodule was confirmed as granulomatous PJP by video-assisted thoracoscopic surgery biopsy.
Aged ; Antibodies, Monoclonal, Murine-Derived/adverse effects/therapeutic use ; Antineoplastic Agents/adverse effects/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Biopsy/methods ; Cyclophosphamide/adverse effects/therapeutic use ; Doxorubicin/adverse effects/therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy/microbiology ; Pneumocystis jirovecii/pathogenicity ; Pneumonia, Pneumocystis/*diagnosis/*radiography ; Positron-Emission Tomography ; Prednisone/adverse effects/therapeutic use ; Solitary Pulmonary Nodule/*microbiology ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed ; Vincristine/adverse effects/therapeutic use

BACKGROUND/AIMS: The aim of this study was to investigate the frequency of disseminated gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the role of bone marrow study in the initial staging work-up. METHODS: A total of 194 patients with gastric MALT lymphoma was enrolled. The incidence of disseminated disease was evaluated in the initial staging work-up. The demographic data and tumor characteristics were compared according to Helicobacter pylori infection status. RESULTS: Localized disease of Lugano stage I accounted for 97.4% of the enrolled cases. Abdominal computed tomography revealed abdominal lymph node metastasis in five patients (2.6%). Bone marrow (BM) involvement was found in only one patient without H. pylori infection (0.5%). No patient showed positive findings on chest computed tomography or positron emission tomography. H. pylori-negative cases showed a significantly higher frequency of advanced-stage disease than H. pylori-positive cases (10.0% vs 0.6%). In patients achieving complete remission, no extragastric recurrence occurred during follow-up. CONCLUSIONS: The incidence of disseminated disease, including BM involvement, was very low in Korean gastric MALT lymphoma patients. It might be beneficial to perform BM aspiration and biopsy as a part of staging work-up only in patients with risk factors for advanced disease such as H. pylori negativity.
Abdomen ; Adult ; Aged ; Bone Marrow/*pathology ; Bone Marrow Examination ; Cohort Studies ; Female ; Helicobacter Infections/*complications ; Humans ; Lymph Nodes/*radiography ; Lymphoma, B-Cell, Marginal Zone/complications/*pathology ; Male ; Mediastinum/radiography ; Middle Aged ; Neoplasm Staging ; Radiography, Abdominal ; Republic of Korea ; Retrospective Studies ; Stomach Neoplasms/complications/*pathology ; Tomography, X-Ray Computed

An Australian cattle dog (case 1: 6-year-old castrated male) and a Shih-Tzu dog (case 2: 8-year-old castrated male) were referred to the Gyeongsang Animal Medical Center due to anorexia and depression. Physical examinations, complete blood counts, serum chemical analysis, radiography, ultrasonography, and bone marrow biopsy were performed. Upon physical examinations of cases 1 and 2, enlargement of superficial lymph nodes was not identified. Hematologic findings in these dogs included leukocytosis with severe lymphocytosis, anemia, and thrombocytopenia. Upon radiography, both dogs showed splenomegaly. Upon examination of a peripheral blood smear in case 1, immature lymphoid cells, featuring decreased nuclear chromatin condensation and nuclear pleomorphism, were present. Biopsy samples of the bone marrow in case 1 revealed hypercellularity as well as a large number of immature lymphoblastic cells similar in shape to cells in the peripheral blood. The characteristic morphological features of peripheral blood and bone marrow samples in case 2 were small lymphocytes. Thus, the dogs were tentatively diagnosed with acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CLL), respectively. After diagnosis, the CLL patient was administered chlorambucil and prednisolone therapy. Due to its similarity to human leukemia, the canine leukemia model provides a valuable model for research into human leukemia.
Anemia ; Animals ; Anorexia ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cattle ; Child ; Chlorambucil ; Chromatin ; Depression ; Diagnosis ; Dogs* ; Humans ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukocytosis ; Lymph Nodes ; Lymphocytes ; Lymphocytosis ; Lymphoma ; Physical Examination ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisolone ; Radiography ; Splenomegaly ; Thrombocytopenia ; Ultrasonography

No abstract available.
Bone Marrow/*pathology ; Female ; Helicobacter Infections/*complications ; Humans ; Lymph Nodes/*radiography ; Lymphoma, B-Cell, Marginal Zone/*pathology ; Male ; Stomach Neoplasms/*pathology

<b>OBJECTIVEb>To investigate the prognostic value of interim and post-therapy PET-CT in patients with diffuse large B-cell lymphoma.

<b>METHODSb>A retrospective analysis was conducted on data from 116 patients with newly diagnosed diffuse large B-cell lymphoma. 43 patients underwent interim PET-CT after 4 cycles of chemotherapy, 48 patients underwent post-therapy PET-CT after 6-8 cycles of chemotherapy, and 25 patients underwent both interim PET-CT and post-therapy PET-CT. The patients were divided into three groups: complete response group, partial response group and no response group. The therapeutic response was assessed by comparing with baseline PET-CT. PET-CT status was assessed for its ability to predict progression-free survival (PFS) and overall survival (OS). The 2-year PFS rate and 3-year OS rate were evaluated using chi-square test. PFS and OS were estimated according to the Kaplan-Meier method and survival curves were compared by log-rank test.

<b>RESULTSb>Interim PET-CT: The interim PET-CT findings of 42 patients were judged as complete response, 15 were judged as partial response, and the rest 11 were judged as no response. The 2-year PFS rates of the complete response group, partial response group and no response group were 61.9%, 60.0%, and 18.2%, respectively, and the 3-year OS rates were 52.4%, 46.7% and 9.1%, respectively. There were no significant differences between the complete response group and partial response group in 2-year PFS rate and 3-year OS rate (P > 0.05 for both). But there was a significant difference between the partial response group and no response group (P < 0.05). The post-therapy PET-CT findings of 50 patients was judged as complete response, 11 as partial response, and the rest 12 were judged as no response. The 2-year PFS rate of the complete response group, partial response group and no response group were 82.0%, 45.5%, and 8.3%, respectively, and the 3-year OS rates were 88.0%, 54.5%, and 8.3%, respectively. There were significant differences between the complete response group and partial response group in 2-year PFS rate and 3-year OS rate (P < 0.05), and there was a significant difference between the partial response group and no response group (P < 0.05).

<b>CONCLUSIONSb>Compared with the interim PET-CT, post-therapy PET-CT can accurately evaluate the prognosis of patients with DLBCL. Interim PET-CT cannot define the prognosis of the complete response and partial response patients.

Adult ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Prognosis ; Radiography ; Remission Induction ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate CT and 18F-flurodeoxyglucose (18F-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). MATERIALS AND METHODS: From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 18F-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. RESULTS: A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n = 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 18F-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. CONCLUSION: Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 18F-FDG-PET/CT.
Adult ; Biopsy ; Bronchi/pathology ; Female ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Immunohistochemistry ; Lymphoid Tissue/pathology ; Lymphoma, B-Cell, Marginal Zone/pathology/*radiography/radionuclide imaging ; Male ; Middle Aged ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

No abstract available.
Acute Disease ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Cyclophosphamide/therapeutic use ; Doxorubicin/therapeutic use ; Female ; Hepatitis/radiography ; Humans ; Liver Neoplasms/*radiography/ultrasonography ; Lymphoma/*radiography/ultrasonography ; Lymphoma, Large B-Cell, Diffuse/pathology ; Lymphoma, T-Cell/drug therapy/pathology ; Male ; Middle Aged ; Prednisone/therapeutic use ; Tomography, X-Ray Computed ; Vincristine/therapeutic use