Lenograstim-Induced Nodal Extramedullary Hematopoiesis: A Challenging Diagnosis in Lymphoma Evaluation With 18F-FDG PET/CT

Clin Nucl Med. 2020 Aug;45(8):e373-e375. doi: 10.1097/RLU.0000000000003111.

Abstract

We report the case of a 23-year-old man with nodal EMH (extramedullary hematopoiesis) occurring during treatment for a stage IIA "gray-zone" lymphoma. Although it is often related to myeloproliferative bone marrow disease, benign etiologies such as lenograstim treatment after chemotherapy can also induce EMH and be responsible for false-positive F-FDG PET/CT examinations. In this respect, GLUT overexpression in hematopoietic lineages and macrophages of the inflammatory environment are responsible for increased F-FDG uptake. Histopathologic confirmation of new hypermetabolic lesions on follow-up PET/CT may be required when the new lesions do not conform with the treatment responses in the preexisting lesions.

Publication types

  • Case Reports

MeSH terms

  • Fluorodeoxyglucose F18*
  • Hematopoiesis, Extramedullary / drug effects*
  • Humans
  • Lenograstim / adverse effects*
  • Lymphoma / diagnostic imaging
  • Lymphoma / drug therapy*
  • Lymphoma / pathology*
  • Male
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography*
  • Young Adult

Substances

  • Fluorodeoxyglucose F18
  • Lenograstim