Granulomatosis after autologous stem cell transplantation in nonHodgkin lymphoma - experience of single institution and a review of literature

Radiol Oncol. 2016 Nov 9;50(4):355-359. doi: 10.1515/raon-2015-0033. eCollection 2016 Dec 1.

Abstract

Background: Sarcoidosis before and after treatment of malignancy is an important differential diagnosis that has to be distinguished from lymphoma.

Patients and methods: Hodgkin lymphoma, diffuse large B-cell lymphoma and aggressive follicular lymphoma are being staged and treatment effect is evaluated with PET-CT. We report three cases of aggressive lymphoma after high dose therapy and autologous stem cell transplantation with positive lymph nodes on PET-CT, which were histologically diagnosed as sarcoidosis/granulomatosis. In the literature, we found that false positive lymph nodes were more common after allogeneic than after autologous transplantation.

Conclusions: Post-treatment PET-CT positive lymph nodes should always be examined histologically prior to any further treatment decision to avoid unnecessary toxic procedures.

Keywords: PET-CT; differential diagnosis; granulomatosis; nonHodgkin lymphoma; tissue biopsy.