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

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

Author information

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


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.


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

Conflict of interest statement

Compliance with Ethical StandardsHugo J.A. Adams: no conflict of interest. John M.H. de Klerk: no conflict of interest. Josien C. Regelink: no conflict of interest. Ben. G.F. Heggelman: no conflict of interest. Stefan V. Dubois: no conflict of interest. Thomas C. Kwee; no conflict of interest.The study was approved by an institutional review board or equivalent and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects in the study gave written informed consent or the institutional review board waived the need to obtain informed consent.This work was financially supported by an Alpe d’HuZes/Dutch Cancer Society Bas Mulder Award for T.C.K. (grant number 5409). Data collection, data analysis, and interpretation of data, writing of the paper, and decision to submit were left to the authors’ discretion and were not influenced by Alpe d’HuZes/Dutch Cancer Society.

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