Radiation-Induced Giant Cell Granuloma Mimicking Relapsed Hodgkin Lymphoma at FDG-PET/CT

Hugo J A Adams; John M H de Klerk; Josien C Regelink; Ben G F Heggelman; Stefan V Dubois; Thomas C Kwee

doi:10.1007/s13139-016-0426-9

Radiation-Induced Giant Cell Granuloma Mimicking Relapsed Hodgkin Lymphoma at FDG-PET/CT

Nucl Med Mol Imaging. 2017 Dec;51(4):371-373. doi: 10.1007/s13139-016-0426-9. Epub 2016 Jun 8.

Authors

Hugo J A Adams¹, John M H de Klerk², Josien C Regelink³, Ben G F Heggelman⁴, Stefan V Dubois⁵, Thomas C Kwee¹

Affiliations

¹ Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
² Department of Nuclear Medicine, Meander Medical Center, Amersfoort, The Netherlands.
³ Department of Hematology, Meander Medical Center, Amersfoort, The Netherlands.
⁴ Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands.
⁵ Department of Pathology, Meander Medical Center, Amersfoort, The Netherlands.

Abstract

A 22-year-old woman was diagnosed with intermediate risk stage II Hodgkin lymphoma and treated with three cycles of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by involved-field radiation therapy. A complete metabolic remission was achieved after two cycles of ABVD, which was maintained until three years after completion of treatment. Follow-up FDG-PET/CT four years after completion of treatment, however, showed a new FDG-avid (Deauville score of 4) lesion in the right scapula, suggesting relapsed disease. Computer tomography (CT)-guided biopsy of this lesion was performed and subsequent histological examination revealed a radiation-induced giant cell granuloma.

Keywords: Biopsy; FDG-PET/CT; Giant cell granuloma; Hodgkin lymphoma.