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

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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.

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Reference

  1. Forte V, Shimotakahara S, Crysdale WS, Thorner P. Recurring giant-cell granuloma at the site of previous radiation therapy. J Otolaryngol. 1990;19:285–7.

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Acknowledgement

We thank the Netherlands Committee on Bone Tumors for assistance in interpreting the histopathological slides.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Hugo J. A. Adams & Thomas C. Kwee

  2. Department of Nuclear Medicine, Meander Medical Center, Amersfoort, The Netherlands

    John M. H. de Klerk

  3. Department of Hematology, Meander Medical Center, Amersfoort, The Netherlands

    Josien C. Regelink

  4. Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands

    Ben G. F. Heggelman

  5. Department of Pathology, Meander Medical Center, Amersfoort, The Netherlands

    Stefan V. Dubois

Authors
  1. Hugo J. A. Adams
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  2. John M. H. de Klerk
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  3. Josien C. Regelink
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  4. Ben G. F. Heggelman
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  5. Stefan V. Dubois
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  6. Thomas C. Kwee
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Corresponding author

Correspondence to Hugo J. A. Adams.

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Conflict of Interest

Hugo 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.

Ethical Statement

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.

Funding

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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This manuscript has not been published before or is not under consideration for publication anywhere else and has been approved by all co-authors.

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Adams, H.J.A., de Klerk, J.M.H., Regelink, J.C. et al. Radiation-Induced Giant Cell Granuloma Mimicking Relapsed Hodgkin Lymphoma at FDG-PET/CT. Nucl Med Mol Imaging 51, 371–373 (2017). https://doi.org/10.1007/s13139-016-0426-9

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  • DOI: https://doi.org/10.1007/s13139-016-0426-9

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