Download PDF
CC BY 4.0 · World J Nucl Med 2023; 22(04): 306-309
DOI: 10.1055/s-0043-1777694
Case Report

Differentiating Hodgkin Lymphoma and Sarcoid Reaction in Subsequent FDG-PET/CT: A Case Report and Literature Review

Obayda Rabei
1   Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), 202 Queen Rania St., P.O. Box 1269, Amman, Jordan
,
Ula Al-Rasheed
1   Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), 202 Queen Rania St., P.O. Box 1269, Amman, Jordan
,
Mohammed Alrammahi 
1   Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), 202 Queen Rania St., P.O. Box 1269, Amman, Jordan
,
Akram Al-Ibraheem 
1   Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), 202 Queen Rania St., P.O. Box 1269, Amman, Jordan
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Sarcoidosis is frequently associated with various hematological and solid tumors; it can be discovered by chance during tumor evaluations. Sarcoidosis can occur before some cancers, coexist with others, or be diagnosed 1 to 2 years later. Sarcoid reaction affecting hilar and mediastinal lymph nodes can pose a diagnostic challenge in patients with histopathological confirmation of Hodgkin lymphoma who are being evaluated using fluorodeoxyglucose-positron emission tomography computed tomography (FDG-PET/CT) scan because it cannot be easily distinguished from lymphoma infiltration. The presence of an increase or persistence of a prominent activity on a follow-up FDG-PET/CT scan after chemotherapy treatment for lymphoma that is associated with a complete metabolic response in the site of the primarily diagnosed lymphomatous disease is highly suggestive of concurrent sarcoidosis and necessitates careful assessment to avoid unnecessary therapy.

Keywords

FDG-PET/CT - Hodgkin lymphoma - sarcoid reaction - sarcoidosis - diagnostic challenge

Ethics Approval

All procedures performed were by the ethical standards of the institutional and/or national research committee and with the Helsinki Declaration as revised in 2013 and its later amendments or comparable ethical standards.


Informed Consent

Consent was obtained properly.




Publication History

Article published online:
26 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Brincker H, Wilbek E. The incidence of malignant tumours in patients with respiratory sarcoidosis. Br J Cancer 1974; 29 (03) 247-251
    CrossrefPubMedGoogle Scholar
  • 2 Cohen PR, Kurzrock R. Sarcoidosis and malignancy. Clin Dermatol 2007; 25 (03) 326-333
    CrossrefPubMedGoogle Scholar
  • 3 Kadin ME, Glatstein E, Dorfman RF. Clinicopathologic studies of 117 untreated patients subjected to laparotomy for the staging of Hodgkin's disease. Cancer 1971; 27 (06) 1277-1294
    CrossrefPubMedGoogle Scholar
  • 4 Kim H, Dorfman RF. Morphological studies of 84 untreated patients subjected to laparotomy for the staging of non-Hodgkin's lymphomas. Cancer 1974; 33 (03) 657-674
    CrossrefPubMedGoogle Scholar
  • 5 Brincker H. Sarcoid reactions in malignant tumours. Cancer Treat Rev 1986; 13 (03) 147-156
    CrossrefPubMedGoogle Scholar
  • 6 London J, Grados A, Fermé C. et al. Sarcoidosis occurring after lymphoma: report of 14 patients and review of the literature. Medicine (Baltimore) 2014; 93 (21) e121
    CrossrefPubMedGoogle Scholar
  • 7 Al-Ibraheem A, Mottaghy FM, Juweid ME. PET/CT in Hodgkin lymphoma: an Update. Semin Nucl Med 2023; 53 (03) 303-319
    CrossrefPubMedGoogle Scholar
  • 8 Al-Ibraheem A, Anwer F, Juweid ME. et al. Interim FDG-PET/CT for therapy monitoring and prognostication in Hodgkin's Lymphoma. Sci Rep 2022; 12 (01) 17702
    CrossrefPubMedGoogle Scholar
  • 9 Reiners KS, Kessler J, Sauer M. et al. Rescue of impaired NK cell activity in Hodgkin lymphoma with bispecific antibodies in vitro and in patients. Mol Ther 2013; 21 (04) 895-903
    CrossrefPubMedGoogle Scholar
  • 10 Diehl V, Sieber M, Rüffer U. et al; The German Hodgkin's Lymphoma Study Group. BEACOPP: an intensified chemotherapy regimen in advanced Hodgkin's disease. Ann Oncol 1997; 8 (02) 143-148
    CrossrefPubMedGoogle Scholar
  • 11 Cocorocchio E, Vanazzi A, Bassi S. et al. Intensified ChlVPP/ABVVP chemotherapy regimen and pegfilgrastim support in advanced Hodgkin lymphoma. Ecancermedicalscience 2010; 4 (01) 184
    PubMedGoogle Scholar
  • 12 Behringer K, Mueller H, Goergen H. et al. Gonadal function and fertility in survivors after Hodgkin lymphoma treatment within the German Hodgkin Study Group HD13 to HD15 trials. J Clin Oncol 2013; 31 (02) 231-239
    CrossrefPubMedGoogle Scholar
  • 13 Al-Ibraheem A, Abdlkadir AS, Juweid ME. et al. FDG-PET/CT in the monitoring of lymphoma immunotherapy response: current status and future prospects. Cancers (Basel) 2023; 15 (04) 1063
    CrossrefPubMedGoogle Scholar
  • 14 Dick J, Begent RH, Meyer T. Sarcoidosis and testicular cancer: a case series and literature review. Urol Oncol 2010; 28 (04) 350-354
    CrossrefPubMedGoogle Scholar
  • 15 Papanikolaou IC, Sharma OP. The relationship between sarcoidosis and lymphoma. Eur Respir J 2010; 36 (05) 1207-1209
    CrossrefPubMedGoogle Scholar
  • 16 Lu Y, Macapinlac H. Identify sarcoid-like reaction in cancer patients receiving chemotherapy and immunotherapy: don't get into the weeds of SUVmax. J Nucl Med 2018; 59 (Suppl. 01) 1194-1194
    Google Scholar
  • 17 Kang HJ, Kim Y, Bae JY, Chang JH, Lee SH. Sarcoid-like reaction after complete remission of malignancy: CT and 18F-FDG PET/CT features for the differential diagnosis from lymph node metastasis. Daehan Yeongsang Uihakoeji 2021; 82 (04) 903-913
    Google Scholar