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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

Posttherapy positron emission tomography/computed tomography: Near complete resolution of the ulceroproliferative lesion in the right thigh (long thin arrow - a) and the lesions in the chest wall and left thigh. No change noted in the extent of axillary and inguinal lymphadenopathy (thick arrows - a, c). However, mild progression is seen in overall extent of cutaneous involvement on the maximal intensity projection image (short thin arrows - a)
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Figure 2: Posttherapy positron emission tomography/computed tomography: Near complete resolution of the ulceroproliferative lesion in the right thigh (long thin arrow - a) and the lesions in the chest wall and left thigh. No change noted in the extent of axillary and inguinal lymphadenopathy (thick arrows - a, c). However, mild progression is seen in overall extent of cutaneous involvement on the maximal intensity projection image (short thin arrows - a)

Mentions: Repeat [18F]-FDG PET/CT was performed a year after the completion of chemoradiotherapy using the same protocol. This revealed near complete resolution of the ulceroproliferative lesion in the right thigh and the lesions in the chest wall and left thigh [Figure 2]. There was no significant change in the extent of axillary and inguinal lymphadenopathy. However, there was a mild progression in the overall extent of cutaneous involvement as evidenced by subtle areas of diffusely increased uptake on the rest of the skin surface. In view of this finding, she was advised to apply a combination of topical corticosteroid (clobetasol propionate 0.5%) with topical emollients in a ratio of 1:1 over the entire skin.


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)

Posttherapy positron emission tomography/computed tomography: Near complete resolution of the ulceroproliferative lesion in the right thigh (long thin arrow - a) and the lesions in the chest wall and left thigh. No change noted in the extent of axillary and inguinal lymphadenopathy (thick arrows - a, c). However, mild progression is seen in overall extent of cutaneous involvement on the maximal intensity projection image (short thin arrows - a)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Posttherapy positron emission tomography/computed tomography: Near complete resolution of the ulceroproliferative lesion in the right thigh (long thin arrow - a) and the lesions in the chest wall and left thigh. No change noted in the extent of axillary and inguinal lymphadenopathy (thick arrows - a, c). However, mild progression is seen in overall extent of cutaneous involvement on the maximal intensity projection image (short thin arrows - a)
Mentions: Repeat [18F]-FDG PET/CT was performed a year after the completion of chemoradiotherapy using the same protocol. This revealed near complete resolution of the ulceroproliferative lesion in the right thigh and the lesions in the chest wall and left thigh [Figure 2]. There was no significant change in the extent of axillary and inguinal lymphadenopathy. However, there was a mild progression in the overall extent of cutaneous involvement as evidenced by subtle areas of diffusely increased uptake on the rest of the skin surface. In view of this finding, she was advised to apply a combination of topical corticosteroid (clobetasol propionate 0.5%) with topical emollients in a ratio of 1:1 over the entire skin.

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