18F-FDG PET/CT for identifying the potential causes and extent of secondary hemophagocytic lymphohistiocytosis
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Nuclear Medicine and Molecular Imaging - Original Article
P: 471-475
September 2016

18F-FDG PET/CT for identifying the potential causes and extent of secondary hemophagocytic lymphohistiocytosis

Diagn Interv Radiol 2016;22(5):471-475
1. Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
2. Department of Radiology, Children’ s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
3. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
No information available.
No information available
Received Date: 16.07.2015
Accepted Date: 12.01.2016
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ABSTRACT

PURPOSE:

We aimed to evaluate the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) for identifying the possible causes of secondary hemophagocytic lymphohistiocytosis (HLH).

METHODS:

Forty-five cases (17 female, 28 male; age, 17–79 years) with secondary HLH were included. The standard of reference for diagnosis in all patients was a combination of histology, clinical results (medical history, physical examination, and laboratory test results), and follow-up imaging for at least 12 months. All cases underwent 18F-FDG PET/CT to identify the possible trigger in HLH.

RESULTS:

Of 45 secondary HLH cases 10 (22.2%) were associated with infection, seven (15.6%) with rheumatic disease, and 28 (62.2%) with lymphoma. PET/CT images of 22 secondary HLH cases (48.9%) showed true positive results. PET/CT images demonstrated obvious tracer uptake in five of 10 secondary HLH cases with infection, one of three cases with lupus, two of two cases with rheumatoid arthritis, one of two cases with adult-onset Still disease, and 13 of 28 cases with lymphoma.

CONCLUSION:

PET/CT is helpful for identifying the possible trigger (infection or malignant disease) and extent of secondary HLH. However, PET/CT alone is not sufficient to make a correct differential diagnosis.