A 28-year-old female patient with active and difficult-to-treat systemic lupus
erythematosus (SLE) was diagnosed with liver-dominant diffused large B-cell
lymphoma. Repeated response 18F-FDG-PET studies showed persistently high, and,
despite intensified immunochemotherapy, further increasing metabolic activity of one of
the hepatic lymphoma residuals, whereas all other initial lymphoma manifestations had
achieved complete metabolic remission. As biopsy of the 18F-FDG-PET-positive liver
residual turned out to be inconclusive, complete resection was performed. Subsequent
histopathological examination, however, revealed only necrotic tissue. Thus, no further
lymphoma treatment was scheduled. The patient undergoes regular surveillance and is
disease-free 13 months after resection. Similarly, treatment of SLE is no longer required
due to lack of activity already after the first two cycles of lymphoma treatment. The case
shows how closely SLE and diffused large B-cell lymphoma can be connected and
stresses the importance of interdisciplinary treatment approaches. In the future, artificial
intelligence may help to further classify 18F-FDG-PET-positive lymphoma residuals. This
could lead to an increase of the positive predictive value of interim- and end-of-treatment
18F-FDG-PET. The patient’s point of view enables another instructive perspective on the
course of treatment, which often remains hidden to treating physicians due to lack of time
in clinical routine.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84567 |
| Date | 05 April 2023 |
| Creators | Kurch, Lars, Georgi, Thomas W., Monecke, Astrid, Seehofer, Daniel, Borte, Gudrun, Sabri, Osama, Kluge, Regine, Heyn, Simone, Pierer, Matthias, Platzbecker, Uwe, Kayser, Sabine |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2234-943X, 798757 |
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