Limits...
Mycosis fungoides: Positron emission tomography/computed tomography in staging and monitoring the effect of therapy.

D'Souza MM, D'Souza P, Sharma R, Jaimini A, Mondal A - Indian J Nucl Med (2015 Apr-Jun)

Bottom Line: The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement.A multidisciplinary approach to the diagnosis, staging and treatment of MF has long been suggested for optimizing outcomes from management of patients with this disease.This case highlights the potential role of incorporating PET/CT as a single modality imaging technique in the staging and assessment of response to therapy.

View Article: PubMed Central - PubMed

Affiliation: Division of PET Imaging, Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.

ABSTRACT
A 58-year-old woman, diagnosed as a case of mycosis fungoides (MF), underwent [18F]-fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) examination. The study revealed intense FDG uptake in a large ulceroproliferative right thigh lesion, indurated plaques in the chest wall and left thigh, along with multiple sites of cutaneous involvement, axillary and inguinal lymphadenopathy. The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement. Repeat [18F]-FDG PET/CT study performed a year later, showed near complete disease regression specifically of the ulceroproliferative lesion and indurated cutaneous plaques, no change in lymphadenopathy, and a subtle diffuse progression of the remaining cutaneous lesions. A multidisciplinary approach to the diagnosis, staging and treatment of MF has long been suggested for optimizing outcomes from management of patients with this disease. This case highlights the potential role of incorporating PET/CT as a single modality imaging technique in the staging and assessment of response to therapy.

No MeSH data available.


Related in: MedlinePlus

Baseline positron emission tomography/computed tomography: Increased fluoro-D-glucose (FDG) uptake noted at multiple cutaneous sites (short thin arrow) and bilateral axillary and inguinal lymph nodes (thick arrows) seen on the maximal intensity projection (a) and transaxial image (c). An intensely FDG avid ulcerative lesion noted on the anterior aspect of the right thigh and on indurated plaques in chest wall and left thigh (long thin arrow - a, b)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4379681&req=5

Figure 1: Baseline positron emission tomography/computed tomography: Increased fluoro-D-glucose (FDG) uptake noted at multiple cutaneous sites (short thin arrow) and bilateral axillary and inguinal lymph nodes (thick arrows) seen on the maximal intensity projection (a) and transaxial image (c). An intensely FDG avid ulcerative lesion noted on the anterior aspect of the right thigh and on indurated plaques in chest wall and left thigh (long thin arrow - a, b)

Mentions: The patient subsequently underwent a whole body [18F]-fluoro-D-glucose (FDG) PET/CT examination on a Discovery STE16 (GE Healthcare, Milwaukee, USA) camera, after administration of 10 mCi of [18F]-FDG. This revealed multiple foci of increased FDG uptake on the skin, which was well seen on the maximal intensity projection (MIP) image as well as the transaxial PET and fused PET/CT images [Figure 1]. An intensely FDG avid ulcerative lesion was noted on the anterior aspect of the skin of the right thigh, extending deeply into the subcutaneous tissue. There was no underlying muscle involvement. Although the lesion was obvious clinically, the depth of involvement could be appreciated only on the PET/CT image. The plaques noted in the left thigh and chest wall on clinical examination also showed increased uptake. Hypermetabolic bilateral axillary and inguinal lymph-nodes were also visualized. The metabolically active left inguinal lymph-node was subjected to biopsy which revealed dermatopathic lymphadenopathy. Bone marrow biopsy performed at the iliac crest as part of the routine work-up (despite absence of abnormal uptake) proved to be negative.


Mycosis fungoides: Positron emission tomography/computed tomography in staging and monitoring the effect of therapy.

D'Souza MM, D'Souza P, Sharma R, Jaimini A, Mondal A - Indian J Nucl Med (2015 Apr-Jun)

Baseline positron emission tomography/computed tomography: Increased fluoro-D-glucose (FDG) uptake noted at multiple cutaneous sites (short thin arrow) and bilateral axillary and inguinal lymph nodes (thick arrows) seen on the maximal intensity projection (a) and transaxial image (c). An intensely FDG avid ulcerative lesion noted on the anterior aspect of the right thigh and on indurated plaques in chest wall and left thigh (long thin arrow - a, b)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4379681&req=5

Figure 1: Baseline positron emission tomography/computed tomography: Increased fluoro-D-glucose (FDG) uptake noted at multiple cutaneous sites (short thin arrow) and bilateral axillary and inguinal lymph nodes (thick arrows) seen on the maximal intensity projection (a) and transaxial image (c). An intensely FDG avid ulcerative lesion noted on the anterior aspect of the right thigh and on indurated plaques in chest wall and left thigh (long thin arrow - a, b)
Mentions: The patient subsequently underwent a whole body [18F]-fluoro-D-glucose (FDG) PET/CT examination on a Discovery STE16 (GE Healthcare, Milwaukee, USA) camera, after administration of 10 mCi of [18F]-FDG. This revealed multiple foci of increased FDG uptake on the skin, which was well seen on the maximal intensity projection (MIP) image as well as the transaxial PET and fused PET/CT images [Figure 1]. An intensely FDG avid ulcerative lesion was noted on the anterior aspect of the skin of the right thigh, extending deeply into the subcutaneous tissue. There was no underlying muscle involvement. Although the lesion was obvious clinically, the depth of involvement could be appreciated only on the PET/CT image. The plaques noted in the left thigh and chest wall on clinical examination also showed increased uptake. Hypermetabolic bilateral axillary and inguinal lymph-nodes were also visualized. The metabolically active left inguinal lymph-node was subjected to biopsy which revealed dermatopathic lymphadenopathy. Bone marrow biopsy performed at the iliac crest as part of the routine work-up (despite absence of abnormal uptake) proved to be negative.

Bottom Line: The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement.A multidisciplinary approach to the diagnosis, staging and treatment of MF has long been suggested for optimizing outcomes from management of patients with this disease.This case highlights the potential role of incorporating PET/CT as a single modality imaging technique in the staging and assessment of response to therapy.

View Article: PubMed Central - PubMed

Affiliation: Division of PET Imaging, Division of PET Imaging, Molecular Imaging and Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India.

ABSTRACT
A 58-year-old woman, diagnosed as a case of mycosis fungoides (MF), underwent [18F]-fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) examination. The study revealed intense FDG uptake in a large ulceroproliferative right thigh lesion, indurated plaques in the chest wall and left thigh, along with multiple sites of cutaneous involvement, axillary and inguinal lymphadenopathy. The patient underwent chemotherapy with CHOP regimen, radiotherapy for the right thigh lesion, along with topical corticosteroids and emollients for the disseminated cutaneous involvement. Repeat [18F]-FDG PET/CT study performed a year later, showed near complete disease regression specifically of the ulceroproliferative lesion and indurated cutaneous plaques, no change in lymphadenopathy, and a subtle diffuse progression of the remaining cutaneous lesions. A multidisciplinary approach to the diagnosis, staging and treatment of MF has long been suggested for optimizing outcomes from management of patients with this disease. This case highlights the potential role of incorporating PET/CT as a single modality imaging technique in the staging and assessment of response to therapy.

No MeSH data available.


Related in: MedlinePlus