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CC BY-NC-ND 4.0 · World J Nucl Med 2020; 19(03): 281-283
DOI: 10.4103/wjnm.WJNM_73_19
Case Report

Rapidly lethal secondary hemophagocytic lymphohistiocytosis predicted by fluorodeoxyglucose positron-emission tomography/computed tomography

Lovemore Makusha
Department of Radiology and Imaging, Yale University School of Medicine, New Haven, CT, USA
,
Darko Pucar
Department of Radiology and Imaging, Yale University School of Medicine, New Haven, CT, USA
,
Colin Young
Department of Radiology and Imaging, Yale University School of Medicine, New Haven, CT, USA
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Abstract

Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare disease with either an indolent or aggressive course. A 29-year-old male presented with fever, polyarthralgias, splenomegaly, retroperitoneal adenopathy, and laboratory findings consistent with Epstein—Barr-mediated sHLH. Consistent with a prior survival analysis by Kim et al., splenic maximum standardized uptake value (SUVmax) >2.52 and bone marrow SUVmax>3.13 on 18F-fuorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) predicted an aggressive disease with poor treatment response. Despite optimal treatment, the patient rapidly progressed to death within 3 months of symptom onset. This case underscores the potential lethal nature of sHLH, and the evolving role of 18FDG-PET/CT in predicting disease severity and treatment response.

Keywords

Fluorodeoxyglucose positron emission tomography/computed tomography - maximum standardized uptake value - rapidly lethal - secondary hemophagocytic lymphohistiocytosis - survival analysis

Financial support and sponsorship

Nil.




Publication History

Received: 27 September 2019

Accepted: 06 October 2019

Article published online:
19 April 2022

© 2020. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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