| PET/CT in the evaluation of lymphoma in patients with HIV-1 with suppressed viral loads. | |
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MedLine Citation:
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PMID: 18716509 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Positron emission tomography (PET) with F-18 fluorodeoxyglucose detects active lymphoid tissue during HIV-1 infection, with distinct patterns of lymphoid activation correlating to various stages of disease activity. Patients with HIV-1 are at risk for lymphoma, making the differential diagnosis between benign and malignant lymphadenopathy imperative. This study retrospectively evaluated the role of PET/computed tomography (CT) in differentiating active lymphoma from persistent generalized lymphadenopathy in patients with HIV-1. MATERIALS AND METHODS: Seven patients with HIV-1 underwent PET/CT. Six, with known non-Hodgkin lymphoma underwent a total of 16 PET/CT scans; 5/16 scans were performed for initial staging, and 10/16 for evaluating treatment response and follow-up. One patient was referred for evaluation of lymphadenopathy suspected of being lymphoma. PET/CT findings were compared with concurrent clinical, immunologic, and virological data. RESULTS: PET/CT accurately depicted the extent of lymphoma in 12/16 patients' scans (75%), yet in 4/16 (25%) scans increased fluorodeoxyglucose uptake was noted in lymph nodes of normal CT appearance (PET+/CT-). Viral loads ranged from 0 to 84,000 copies/mL, CD4 T-cell count ranged from 130 to 474 cells/muL in the group. The highest values of both laboratory parameters were concurrent with the discrepant PET+/CT- scans, seen in 4 scans, in 2 patients. The PET+/CT- findings in both these patients were observed in neck, axillae, mediastinum, spleen, and inguinal regions, and sample biopsies of the PET (+) nodes consequently proved benign findings in both patients. All PET+/CT+ findings correctly indicated lymphoma status, as proven by clinical follow-up. CONCLUSION: PET/CT accurately detected lymphoma in patients with HIV-1 and had been used confidently as a management tool in this patient group. In the context of discrepant PET/CT findings, increased viral loads and CD4 levels may imply benign HIV-related lymphadenopathy. |
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Authors:
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Elinor Goshen; Tima Davidson; Abraham Avigdor; Tzila S Zwas; Itzchak Levy |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical nuclear medicine Volume: 33 ISSN: 1536-0229 ISO Abbreviation: Clin Nucl Med Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-08-21 Completed Date: 2008-11-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7611109 Medline TA: Clin Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 610-4 Citation Subset: IM |
Affiliation:
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Department of Nuclear Medicine, Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel. egoshen@sheba.health.gov.il |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Diagnosis, Differential Female HIV Infections / complications*, virology* Humans Lymphatic Diseases / diagnosis, radiography, radionuclide imaging Lymphoma / complications*, diagnosis*, radiography, radionuclide imaging Male Middle Aged Positron-Emission Tomography Tomography, X-Ray Computed Viral Load* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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