Abstract
Lymphomatoid granulomatosis is a rare extranodal Epstein-Barr virus-driven B-cell lymphoproliferative disease, involving predominantly lung, less often skin, kidney, and central nervous system. Here, we present a pediatric case with primary immunodeficiency, diagnosed with pathologically proven pulmonary grade-III lymphomatoid granulomatosis. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging demonstrated 18F-FDG avid pulmonary masses with central air-bronchograms and cavitations. Although the definitive diagnosis depends on biopsy, 18F-FDG PET/CT serves as a complementary imaging tool to evaluate the extent of the disease and response to treatment.
Keywords: Lymphomatoid granulomatosis, pulmonary involvement, 18F-FDG PET/CT
References
Roschewski M, Wilson WH. Lymphomatoid granulomatosis. Cancer J 2012;18:469-474.
Yang M, Rosenthal AC, Ashman JB, Craig FE. The Role and Pitfall of F18-FDG PET/CT in surveillance of high grade pulmonary lymphomatoid granulomatosis. Curr Probl Diagn Radiol 2021;50:443-449.
Melani C, Jaffe ES, Wilson WH. Pathobiology and treatment of lymphomatoid granulomatosis, a rare EBV-driven disorder. Blood 2020;135:1344-1352.
Tacke ZC, Eikelenboom MJ, Vermeulen RJ, van der Knaap MS, Euser AM, van der Valk P, Kaspers GJ. Childhood lymphomatoid granulomatosis: a report of 2 cases and review of the literature. J Pediatr Hematol Oncol 2014;36:416-422.
Chung JH, Wu CC, Gilman MD, Palmer EL, Hasserjian RP, Shepard JA. Lymphomatoid granulomatosis: CT and FDG-PET findings. Korean J Radiol 2011;12:671-678.
Sood A, Parihar AS, Malhotra P, Vaiphei K, Kumar R, Singh H, Mittal BR. Pulmonary recurrence of lymphomatoid granulomatosis diagnosed on F-18 FDG PET/CT. Indian J Nucl Med 2020;35:167-169.
Makis W, Deschenes J. Cerebral and pulmonary lymphomatoid granulomatosis and EBV positive oesophageal ulcer in an immunosuppressed renal transplant patient staged and followed with serial MRI and 18F-FDG PET/CT after rituximab therapy. BJR Case Rep 2016;2:20150503.
Nishihara H, Nakasato M, Sawa H, Murakami H, Yamamoto D, Moriyama K, Kato N, Hashimoto I, Kamada H, Tanaka S. A case of central nervous system lymphomatoid granulomatosis; characteristics of PET imaging and pathological findings. J Neurooncol 2009;93:275-278.
Kawai N, Miyake K, Nishiyama Y, Yamamoto Y, Sasakawa Y, Haba R, Kushida Y, Tamiya T, Nagao S. FDG-PET findings of the brain in lymphomatoid granulomatosis. Ann Nucl Med 2006;20:683-687.
Martínez-Esteve A, Álvarez-Pérez RM, García-Gómez FJ, Acevedo-Báñez I, Cuenca-Cuenca JI, Borrego-Dorado I. Paediatric grade-II lymphomatoid granulomatosis: (18)F-FDG PET/CT monitoring of disease activity. Rev Esp Med Nucl Imagen Mol 2016;35:131-132.
