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

We present an interesting case of incidental diffuse fluorodeoxyglucose (FDG) uptake at PET in her left breast, related to atypical breastfeeding practice. Clinically, differential diagnoses of diffuse intense FDG uptake in unilateral breast include advanced breast cancer, breast lymphoma and inflammatory condition. However, normal physiologic lactation may also show increased FDG uptake in the breasts. Therefore, if we encounter that finding in daily practice, we should question the patient regarding unilateral breastfeeding. In addition, mammography and ultrasound would be helpful to confirm the diagnosis.
Adult ; Breast/*metabolism/radionuclide imaging ; Breast Feeding/*methods ; Breast Neoplasms/radionuclide imaging ; Diagnosis, Differential ; Female ; Fluorodeoxyglucose F18/diagnostic use/*pharmacokinetics ; Humans ; Lactation/metabolism ; Lymphoma/radionuclide imaging ; Mammography ; Positron-Emission Tomography ; Radiopharmaceuticals/diagnostic use/*pharmacokinetics ; Ultrasonography, Mammary

OBJECTIVETo investigate the clinical and laboratory characteristics of tumor like Sjögren's syndrome (TLSS) patients and non-tumor like Sjögren's syndrome (NTLSS) and the incidence of lymphoma in patients of Sjögren's syndrome (SS).

METHODSA retrospective analysis was carried out in 199 primary SS (including TLSS) patients who were recruited in Peking University School and Hospital of Stomatology from 1998 to 2010. Clinical and laboratory information were collected. The patients were divided into two groups: TLSS (n = 25) and NTLSS (n = 174). Clinical and laboratory characteristics were compared between these two groups by a statistical analysis.

RESULTSOf the 25 TLSS patients, 23 had enlargements of parotid glands and 2 had enlargements of submandibular glands. There were significant differences of salivary scintigraphy appearance (P = 0.018), hypergammaglobulinemia (P = 0.014), rheumatoid factor positive rate (P = 0.001), formation of the ectopic germinal centers (P = 0.014), double positive rate of anti-SSA antibody and anti-SSB antibody (P < 0.001) between the TLSS and NTLSS patients. Among the 25 TLSS patients, 3 developed lymphomas, accounting for 1.5% (3/199) of the total 199 patients and 12% (3/25) of the TLSS patients. Lymphoma subtypes included one diffused large B-cell lymphoma and two mucosa-associated lymphoid tissue lymphoma. There was no lymphoma detected in NTLSS patients.

CONCLUSIONSThere are clinical and laboratory differences between TLSS and NTLSS patients, with a more tendency to develop lymphomas in TLSS patients.

Adult ; Antibodies, Antinuclear ; metabolism ; Female ; Humans ; Hypergammaglobulinemia ; metabolism ; Lymphoma, B-Cell, Marginal Zone ; diagnostic imaging ; etiology ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnostic imaging ; etiology ; metabolism ; pathology ; Male ; Middle Aged ; Parotid Gland ; pathology ; Radionuclide Imaging ; Retrospective Studies ; Rheumatoid Factor ; metabolism ; Salivary Glands ; diagnostic imaging ; Sjogren's Syndrome ; complications ; diagnostic imaging ; metabolism ; pathology ; Submandibular Gland ; pathology

Extra marginal-zone lymphomas of the lung is a very rare tumor and it originates from bronchial-associated lymphoid tissue. A 68-yr-old woman presented with productive cough and dyspnea. A thorax computed tomography scan showed a 9 x 10 cm in size mass in the left lung and pleural effusion in the lower lobe of left lung. Positron emission tomography/computed tomography (PET/CT) revealed intense uptake foci at the upper and middle sites of left lung and slight uptake foci at the mediastinal lymph nodes which showed malignant involvement. After bronchoscopic biopsy, the diagnosis of pulmonary bronchial-associated lymphoid tissue (BALT) lymphoma was confirmed. At the end of the eight cycles weekly rituximab treatment, complete response was obtained by PET/CT findings. It is concluded that extended rituximab schedule is more effective and it would be beneficial to investigate the use of PET/CT in the diagnosis and evaluating of the treatment response of pulmonary BALT lymphoma.
Aged ; Antibodies, Monoclonal, Murine-Derived/*administration & dosage ; Antineoplastic Agents/*administration & dosage ; Drug Administration Schedule ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Lung Neoplasms/*drug therapy/pathology/radionuclide imaging ; Lymphoma, B-Cell, Marginal Zone/*drug therapy/pathology/radionuclide imaging ; Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed

Primary pulmonary T-cell lymphoma is an extremely rare malady, and we diagnosed this in a 52-year-old male who was admitted to our hospital with cough for the previous two weeks. The chest CT demonstrated multiple variable sized mass-like consolidations with low density central necrosis in the peripheral portion of both the upper and lower lobes. Positron emission tomography (PET) showed multiple areas of hypermetabolic fluorodeoxyglucose (FDG) uptake in both lungs with central metabolic defects, which correlated with central necrosis seen on CT. The histological sample showed peripheral T-cell lymphoma of the not otherwise specified form. The follow-up CT scan showed an increased extent of the multifocal consolidative lesions despite that the patient had undergone chemotherapy.
Contrast Media/diagnostic use ; Cough/etiology ; Diagnosis, Differential ; Fatal Outcome ; Fever/etiology ; Fluorodeoxyglucose F18/diagnostic use ; Follow-Up Studies ; Humans ; Lung/radiography/radionuclide imaging ; Lung Neoplasms/complications/*radiography/*radionuclide imaging ; Lymphoma, T-Cell/complications/*radiography/*radionuclide imaging ; Male ; Middle Aged ; Pneumonia/complications ; Positron-Emission Tomography/methods ; Radiographic Image Enhancement/methods ; Sweating ; Tomography, X-Ray Computed/methods

PURPOSE: Recombinant ScFv lym-1 was produced, using pET vector system for large scale production. METHODS: ScFv lym-1 gene inserted pET-22b (+) vector, was expressed in E.coli BL-21 strain. ScFv lym-1 antibody extracted from periplasm, was purified with His-Taq column. To evaluated immunoreactivity with Raji cell, ScFv lym-1 was labeled with I-125 and I-125 ScFv lym-1 was purified with desalting column. Raji cell was injected into the C57BR/cdJ SCID mice. Gamma camera imaging were taken time point at 1, 8, 24, and 48 hr with 8 mm pinhole collimator. RESULTS: An active scFv lym-1 could be produced in E.coli with soluble from using pET vector system. Immunoreactivity and affinity constant of IgG lym-1 were 54% and 1.83 x 10(9) M(-1), respectively, and those of scFv lym-1 were 53.7% and 1.46 x 10(9) M(-1), respectively. Biodistribution of I-125 scFv lym-1 antibody showed faster clearance in blood, spleen, kidney and than I-125 IgG lym-1 antibody. Gamma camera image of I-125 scFv lym-1 antibody showed faster clearance and tumor targeting liver than I-125 IgG lym-1 antibody. CONCLUSIONS: In vitro properties of scFv lym-1 were similar to those of IgG lym-1. ScFv lym-1 showed faster blood clearance than IgG lym-1. These results suggest that scFv lym-1 antibody can be useful for tumor imaging agent.
Animals ; Gamma Cameras ; Immunoglobulin G ; Kidney ; Liver ; Lymphoma* ; Mice ; Mice, SCID ; Periplasm ; Radionuclide Imaging ; Spleen

The accurate diagnosis and localization of gastrointestinal bleeding may use many tests and procedures including serial hematocrits, angiography, scintigraphy, endoscopy, nasogastric aspiration, barium studies and surgery before success is achieved. However, lower gastrointestinal (GI) bleeding is difficult to localize despite above diagnostic procedures. We had experienced a case of mucosa associated lymphoid tissue (MALT) lymphoma of jejunum. In this case, a 61-year-old male was admitted to our hospital with recurrent lower GI bleeding. The cause of recurrent lower GI bleeding was not defined by extensive evaluation including gastrofiberoscopy, colonoscopy, mesenteric angiography, small bowel series. We diagnosed this case as low grade B cell MALT lymphoma after exploratory laparatomy due to bowel perforation.
Angiography ; Barium ; Colonoscopy ; Diagnosis ; Endoscopy ; Hematocrit ; Hemorrhage* ; Humans ; Jejunum* ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Middle Aged ; Mucous Membrane* ; Radionuclide Imaging

The accurate staging of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) is an important aspect of treatment. In this study, the authors undertook to prospectively evaluate the clinical value of 2- (fluorine-18) fluoro-2-deoxy-D-glucose position emission tomography (FDG-PET) for the staging of malignant lymphoma as compared with computed tomography and 67Ga scan. Thirty consecutive cases with biopsy-proven lymphoma (4 HD, 26 NHL) were examined by FDG-PET for the initial staging and the restaging work-up between September 2000 and April 2001. The FDG-PET and conventional study, including a CT of the neck, chest, abdomen, and of the pelvis, a bone scan, a 67Ga scan, and a bone marrow study were undertaken to investigate nodal/extranodal manifestations and bone marrow infiltration. In terms of the detection of nodal lymphoma manifestation, the sensitivities and specificities of the PET, CT, and 67Ga scan were determined to be 93.3%, 98.9%, and 25.8%, and 100%, 99.1%, and 99.8%, respectively. In terms of the detection of extranodal lymphoma manifestation, the sensitivities and specificities of the PET, CT, and 67Ga scan were 87.5%, 87.5%, and 37.5%, and 100%, 100%, and 100%, respectively. The FDG-PET proved to be very accurate for the staging of malignant lymphoma and superior to Ga-67 scan. Although the results of PET and CT were substantially comparable, both imaging studies were found to complement each other in some cases with respect to the evaluation of lymphomatous involvement.
Adult ; Aged ; Aged, 80 and over ; Bone and Bones/radionuclide imaging ; Comparative Study ; Female ; Fludeoxyglucose F 18/*diagnostic use ; Gallium Radioisotopes/*diagnostic use ; Human ; Lymph Nodes/pathology ; Lymphoma/*pathology/radiography/radionuclide imaging ; Male ; Middle Aged ; Neoplasm Staging ; Prospective Studies ; *Tomography, Emission-Computed ; *Tomography, X-Ray Computed

PURPOSE: Ga-67 scintigraphy has been used for the evaluation of tumors, especially lymphoma. Recently, Tl-201 and Tc-99m MIBI were also used to tumor imaging. Tl-201 and Tc-99m MIBI had better physiologic characteristics than Ga-67, so we studied 32 biopsy proven lymphoma patients (male 24, female 8, mean age 46 years) with Ga-67, Tl-201 or Tc-99m MIBI and compared the scan findings. MATERIALS AND METHODS: Twenty-three of 32 patients were injected 74-111 MBq (2-3 mCi) of Tl-201, before chemotherapy and imaged with dual-headed SPECT (Prism 2000, Picker, USA) at 30 minutes after injection. Delayed images were obtained after 3 hr in 8 patients. Twenty seven of 32 patients were injected 740 MBq (20 mCi) of Tc-99m MIBI and imaged at 30 minutes after injection. 111-185 MBq (3-5 mCi) of Ga-67 was injected in 12 patients and imaged at 48 and 72 hours after injection. Twenty eight patients were diagnosed as non-Hodgkin's lymphoma and others were Hodgkin's lymphoma. RESULTS: Twenty patients were positive on Tl-201 scan and 3 patients showed negative findings. One of these 3 patients, Tc-99m MIBI and Ga-67 scan were positive. Twenty two patients were positive on Tc-99m MIBI scan and 5 patients showed negative findings. One of these 5 patients, Tl-201 was positive and 2 were positive on Ga-67 scan. Ten of 12 patients showed positive findings on Ga-67 scan. The sensitivity of these agents were 83.3%, 87.0% and 81.5% for Ga-67, Tl-201 and Tc-99m MIBI, respectively. The sensitivity was highest in Tl-201 scan, but there were no significant differences among three tests. In this study, there was no significant difference of uptake ratios between early and delayed images of Tl-201. CONCLUSION: Scintigraphy with Tl-201 and Tc-99m MIBI in lymphoma patients have similar sensitivity with Ga-67.
Biopsy ; Drug Therapy ; Female ; Hodgkin Disease ; Humans ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Radionuclide Imaging ; Tomography, Emission-Computed, Single-Photon

Sjogren's syndrome is a chronic inflammatory disease that predominantly affects salivary, lacrimal, and other exocrine glands. We report a case of Sjogren's syndrome combined with MALT(mucose associated lymphoid tissue) lymphoma which occured in the parotid gland. A 57-year-old female with the complaint of painful swelling and lymph node enlargement was referred to our department. Sialograms of both parotid glands showed globular collections of contrast material uniformly distributed throughout the parotid gland. Salivary scintigraphy showed decreased uptake of the parotid gland. CT scan showed larger, slightly more dense parotid gland than normal and honeycomb glandular appearance. Also, It showed discrete, slightly more enhanced round mass in the left parotid gland. Histopathological finding showed replacement of salivary gland parenchyma with dense small lymphocytic infiltration having the feature of epimyoepithelial islands. Kappa light chain restriction of interglandular plasma cell could be seen.
Exocrine Glands ; Female ; Humans ; Islands ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Middle Aged ; Parotid Gland ; Plasma Cells ; Radionuclide Imaging ; Salivary Glands ; Sjogren's Syndrome* ; Tomography, X-Ray Computed