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. 2014 Jun;23(2):67-9.
doi: 10.4274/mirt.362. Epub 2014 Jun 5.

Detection of Hodgkin Transformation in a Case of Chronic Lymphocytic Leukemia by PET/CT

Sabire Yılmaz  1 , Meftune Ozhan  1 , Sertaç Asa  1 , M Sait Sağer  1 , Fatih Selçuk Biricik  2 , Metin Halaç  1 , Kerim Sönmezoğlu  1
Affiliations

Detection of Hodgkin Transformation in a Case of Chronic Lymphocytic Leukemia by PET/CT

Sabire Yılmaz et al. Mol Imaging Radionucl Ther. 2014 Jun.

Abstract
in English, Turkish

Richter's transformation (RT) represents the development of high grade lymphoma, most commonly diffuse large B-cell lymphoma, in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL). CLL/SLL may convert also to Hodgkin's lymphoma, the so-called Hodgkin's variant of Richter transformation. Histopathological proof is needed to confirm a definitive diagnosis. Patients with RT generally have a poor prognosis, with prompt recognition optimise clinical management. Whole-body PET scan with 18F-FDG can be used for detection of RT of CLL/SLL. We describe the case of 64-year-old woman with CLL/SLL who developed Hodgkin lymphoma detected with PET/CT.

Richter transformasyonu (RT), kronik lenfositik lösemi veya küçük lenfositik lenfoma (KLL) hastalarında en sık diffuz büyük B-hücreli lenfoma olmak üzere yüksek grade lenfoma gelişmesi demektir. KLL ayrıca Hodgkin varyant Richter transformasyonu olarak bilinen Hodgkin lenfomaya da dönüşebilir. Kesin tanı için histopatolojik kanıt gerekir. RT’li hastalar genellikle kötü prognoza sahiptir. Hastalığın erken tanınması optimum klinik müdahaleyi sağlar. 18F-FDG ile tüm vücut PET sintigrafi RT tespit edilmesinde kullanılabilir. Biz bu olguda, 64 yaşındaki bir KLL hastasında Hodgkin lenfoma gelişiminin PET/BT ile saptanmasını paylaşmak istedik.

Keywords: 18F-FDG; Leukemia; chronic; lymphocytic.

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Figures

Figure 1a
Figure 1a. A 64-year-old female patient with CLL/SLL diagnosis. Axial PET, CT, PET/CT fusion and coronal PET/CT fusion images (upper row) of whole-body PET/CT revealed multiple lymph nodes with minimally increased FDG uptake at the right cervical, right supraclavicular, bilateral axillary lymph nodes. There was also minimally increased FDG accumulation at the bilateral internal iliac lypmh nodes (lower row) which was compatible with low FDG uptake of indolent lymphoma.
Figure 1b
Figure 1b. Axial PET, CT, PET/CT fusion and coronal PET/CT fusion images revealed left submandibular and upper-middle jugular conglomerate lymph nodes (short arrow) with intense FDG uptake (SUVmax was 13.0) suggesting transformation. Additionally, minimally increased FDG uptake in the right jugular chain (long arrow) compatible with indolent lymphoma involvement was noted.
See this image and copyright information in PMC

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