Pulmonary drug toxicity: FDG-PET findings in patients with lymphoma |
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Authors: | Toshiki Kazama Silvana C Faria Yoshitaka Uchida Hisao Ito Homer A Macapinlac |
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Institution: | (1) Division of Diagnostic Imaging, the University of Texas M.D. Anderson Cancer Center, Houston, TX, USA;(2) Department of Radiology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan |
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Abstract: | Objective The objective of this study was to evaluate the prevalence and positron emission tomography (PET) imaging features of pulmonary
drug toxicity in patients with lymphoma during or just following chemotherapy.
Methods A total of 677 PET scans on 460 patients with lymphoma (351 non-Hodgkin’s lymphoma, 92 Hodgkin’s disease, and 17 both Hodgkin’s
and non-Hodgkin’s lymphoma) were performed for the evaluation of chemotherapy response. In 51 patients, abnormal accumulation
on both sides of the chest was reported. A review of medical records, 18fluorodeoxyglucose (18FDG)-PET scans, and chest computed tomography (CT) was performed, and cases with probable drug toxicity were identified. Inclusion
criteria of probable drug toxicity were abnormal but symmetrical FDG accumulation in both lungs seen during or just following
the completion of chemotherapy, the abnormal accumulation or corresponding abnormal CT findings resolved on sub sequent studies,
exclusion of clinical diagnosis of pneumonia, radiation pneumonitis, or lymphoma involvement.
Results In 10 patients (six men and four women, average age 47.3), 2.2% of cases, probable drug toxicity was identified. In all 10
cases, diffuse and subpleural-dominant FDG accumulation was seen on FDG-PET scans, and scattered or diffuse ground-glass opacities
were observed on chest CT. Four patients reported symptoms, and six patients did not report any symptoms.
Conclusions Diffuse and peripheral-dominant FDG accumulation in the lung, which may represent pulmonary drug toxicity, was not uncommon
in patients with lymphoma who underwent chemotherapy. FDG-PET scan might be able to detect pulmonary drug toxicity in asymptomatic
patients. |
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Keywords: | FDG PET Lymphoma Lung Chemotherapy |
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