Right Atrium Mass Assessed with 18F-FDG PET/CT Scan Turns Out to Be an Uncommon Relapse of Testicular Diffuse Large B-cell Lymphoma: A Case Report

We report the case of a 71-year-old man affected by testicular large B-cell lymphoma (DLBCL), treated with right orchiectomy and first-line chemotherapy (R-CHOP, 8 cycles). A complete remission was obtained after therapy. Twenty-two months after the primary diagnosis the patient suddenly presented d...

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Bibliographic Details
Published inDiagnostics (Basel) Vol. 10; no. 11; p. 987
Main Authors Panareo, Stefano, Urso, Luca, Santi, Ivan, Rigolin, Gian Matteo, Cuneo, Antonio, Cittanti, Corrado, Bartolomei, Mirco
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 01.11.2020
MDPI
Subjects
Antibiotics
Biopsy
cardiac neoplasms
Case Report
Case reports
Chemotherapy
Conflicts of interest
diffuse
Dyspnea
Hematology
large B-Cell
lymphoma
Medical imaging
Medical prognosis
Metabolism
Patients
PET CT Scan
Pleural effusion
testicular tumors
Veins & arteries
United States > US
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Summary:We report the case of a 71-year-old man affected by testicular large B-cell lymphoma (DLBCL), treated with right orchiectomy and first-line chemotherapy (R-CHOP, 8 cycles). A complete remission was obtained after therapy. Twenty-two months after the primary diagnosis the patient suddenly presented dyspnoea and superior vena cava syndrome; thus, he underwent a CT scan that revealed a large mass in the right atrium, expanding to the superior vena cava. A differential diagnosis between a neoplastic mass and a clot was proposed. The subsequent MR did not clarify the nature of the mass; therefore, the patient underwent an 18F-FDG PET/CT scan (PET/CT), after a specific preparation to reduce fluoro-deoxyglucose (FDG) myocardial uptake. PET/CT revealed an intense FDG uptake involving the whole mass (SUVmax 9.4), suggestive for neoplasm and confirmed by the subsequent endocardiac biopsy. The patient was treated with 8 cycles of R-COMP, obtaining a complete remission, as indicated by the PET/CT performed after the seventh cycle of therapy. The case that we are reporting highlights that DLBCL can have an uncommon relapse presentation in the atrium. PET/CT, compared to conventional imaging, can be a valuable tool to detect early and better characterize cardiac lesions in order to improve the poor prognosis of these conditions.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics10110987