Primary Mediastinal Large B-Cell Lymphoma (Thymic Lymphoma) Imaged With F-18 FDG PET-CT

• Published in: Clinical nuclear medicine Vol. 35; no. 6; pp. 421 - 424
• Main Authors: Makis, William, Derbekyan, Vilma, Hickeson, Marc
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-06-2010
• Subjects: Fluorodeoxyglucose F18; Humans; Lymphoma, B-Cell - diagnostic imaging; Lymphoma, B-Cell - pathology; Lymphoma, B-Cell - physiopathology; Male; Mediastinal Neoplasms - diagnostic imaging; Mediastinal Neoplasms - pathology; Mediastinal Neoplasms - physiopathology; Middle Aged; Positron-Emission Tomography; Tomography, X-Ray Computed
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/RLU.0b013e3181db4d33

Primary mediastinal B-cell lymphoma is believed to arise from a small population of thymic medullary B-cells, and is considered a distinct entity from diffuse large B-cell lymphoma, based on its unique clinical, histopathologic, and molecular features. It represents 2% of all non-Hodgkin lymphomas, and has a propensity to affect young women with a median age of 35 years. It usually presents with a bulky tumor in the anterior mediastinum that is rapidly progressive, causing local compressive symptoms. Although distant spread is infrequent at presentation, this subtype of lymphoma tends to spread to unusual extranodal sites such as liver, kidneys, and central nervous system. We present 2 cases of histologically proven primary mediastinal B-cell lymphoma, which demonstrate this pattern of distant spread to organs including the stomach and pancreas. In these cases, F-18 FDG PET-CT proved very useful in the evaluation of distant spread of the disease.