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Systemic Lupus Erythematosus Associated Pitfalls on 18F-FDG PET/CT: Reactive Follicular Hyperplasia, Kikuchi-Fujimoto Disease, Inflammation and Lymphoid Hyperplasia of the Spleen Mimicking Lymphoma

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Abstract

Systemic lupus erythematosus (SLE) is associated with a variety of inflammatory processes that can affect the lymph nodes, brain, kidneys, and spleen. We present two patients with SLE in whom SLE-associated conditions complicated interpretation of 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging of the lymph nodes and the spleen. The imaging findings mimicked lymphoma, but histopathological evaluation showed benign processes including reactive follicular hyperplasia in the lymph nodes, Kikuchi-Fujimoto disease in perisplenic lymph nodes, and inflammatory changes and lymphoid hyperplasia in the spleen.

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References

  1. Mok CC, Lau CS. Pathogenesis of systemic lupus erythematosus. J Clin Pathol. 2003;56:481–490.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Blanco R, McLaren B, Davis B, Steele P, Smith R. Systemic lupus erythematosus-associated lymphoproliferative disorder: report of a case and discussion in light of the literature. Hum Pathol. 1997;28:980–985.

    Article  CAS  PubMed  Google Scholar 

  3. Kojima M, Nakamura S, Morishita Y, Itoh H, Yoshida K, Ohno Y, et al. Reactive follicular hyperplasia in the lymph node lesions from systemic lupus erythematosus patients: a clinicopathological and immunohistological study of 21 cases. Pathol Int. 2000;50:304–312.

    Article  CAS  PubMed  Google Scholar 

  4. Kojima M, Motoori T, Asano S, Nakamura S. Histological diversity of reactive and atypical proliferative lymph node lesions in systemic lupus erythematosus patients. Pathol Res Pract. 2007;203:423–431.

    Article  PubMed  Google Scholar 

  5. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes. Acta Hematol Jpn. 1972;35:379–380.

    Google Scholar 

  6. Fujimoto Y, Kojima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. Naika. 1972;20:920–927.

    Google Scholar 

  7. Curiel R, Akin EA, Beaulieu G, Depalma L, Hashefi M. PET/CT imaging in systemic lupus erythematosus. Ann NY Acad Sci. 2011;1228:71–80.

    Article  PubMed  Google Scholar 

  8. Kim CH, Hyun OJ, Yoo IR, Kim SH, Sohn HS, Chung SK. Kikuchi disease mimicking malignant lymphoma on FDG PET/CT. Clin Nucl Med. 2007;32:711–712.

    Article  PubMed  Google Scholar 

  9. Tsujikawa T, Tsuchida T, Imamura Y, Kobayashi M, Asahi S, Shimizu K, et al. Kikuchi-Fujimoto disease. PET/CT assessment of a rare cause of cervical lymphadenopathy. Clin Nucl Med. 2011;36:661–664.

    Article  PubMed  Google Scholar 

  10. Quintas-Cardama A, Fraga M, Cozzi SN, Caparrini A, Maceiras F, Forteza J. Fatal Kikuchi-Fujimoto disease: the lupus connection. Ann Hematol. 2003;82:186–188.

    Article  CAS  PubMed  Google Scholar 

  11. el-Ramahi KM, Karrar A, Ali MA. Kikuchi disease and its association with systemic lupus erythematosus. Lupus. 1994;3:409–411.

    Article  CAS  PubMed  Google Scholar 

  12. Santana A, Lessa B, Galrao L, Lima I, Santiago M. Kikuchi-Fujimoto’s disease associated with systemic lupus erythematosus: case report and review of the literature. Clin Rheumatol. 2005;24:60–63.

    Article  PubMed  Google Scholar 

  13. Hu S, Kuo TT, Hong HS. Lupus lymphadenitis simulating Kikuchi’s lymphadenitis in patients with systemic lupus erythematosus: a clinicopathological analysis of six cases and review of literature. Pathol Int. 2003;53:221–226.

    Article  PubMed  Google Scholar 

  14. Lopez C, Oliver M, Olavarria R, Sarabia MA, Chopite M. Kikuchi-Fujimoto necrotizing lymphadenitis associated with cutaneous lupus erythematosus: a case report. Am J Dermatopathol. 2000;22:328–333.

    Article  CAS  PubMed  Google Scholar 

  15. Martinez-Vazquez C, Hughes G, Bordon J, Alonso-Alonso J, Anibarro-Garcia A, Martinez E, et al. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto’s disease, associated with systemic lupus erythematosus. QJM. 1997;90:531–533.

    Article  CAS  PubMed  Google Scholar 

  16. Burnett R, Ravel G, Descotes J. Clinical and histopathological progression of lesions in lupus-prone (NZB x NZW) F1 mice. Exp Toxicol Pathol. 2004;56:37–44.

    Article  PubMed  Google Scholar 

  17. Salaun PY, Gastinne T, Bodet-Milin C, Campion L, Cambefort P, Moreau A, et al. Analysis of 18F-FDG PET diffuse bone marrow uptake and splenic uptake in staging of Hodgkin’s lymphoma: a reflection of disease infiltration or just inflammation? Eur J Nucl Med Mol Imaging. 2009;36:1813–1821.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Imaging, CCI, 11560 University Ave NW, Edmonton, AB, T6G 1Z2, Canada

    William Makis

  2. Nuclear Medicine, MUHC Glen Site, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada

    Anthony Ciarallo

  3. Pathology, MUHC Glen Site, 1001 Decarie Blvd, Montreal, QC, H4A 3J1, Canada

    Milene Gonzalez-Verdecia

  4. Nuclear Medicine, MUHC Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC, H3T 1E2, Canada

    Stephan Probst

Authors
  1. William Makis
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  2. Anthony Ciarallo
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  4. Stephan Probst
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Correspondence to William Makis.

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Conflict of interest

William Makis, Anthony Ciarallo, Milene Gonzalez-Verdecia and Stephan Probst declare that they have 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.

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Makis, W., Ciarallo, A., Gonzalez-Verdecia, M. et al. Systemic Lupus Erythematosus Associated Pitfalls on 18F-FDG PET/CT: Reactive Follicular Hyperplasia, Kikuchi-Fujimoto Disease, Inflammation and Lymphoid Hyperplasia of the Spleen Mimicking Lymphoma. Nucl Med Mol Imaging 52, 74–79 (2018). https://doi.org/10.1007/s13139-017-0471-z

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  • DOI: https://doi.org/10.1007/s13139-017-0471-z

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