Primary Pulmonary Diffuse Large B-cell Lymphoma

Area of Science:

• Oncology
• Radiology
• Nuclear Medicine

Background:

• Primary pulmonary diffuse large B-cell lymphoma (DLBCL) is a rare extranodal non-Hodgkin lymphoma.
• DLBCL can present with non-specific symptoms and imaging findings, leading to diagnostic delays.

Purpose of the Study:

• To describe the unique fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) PET/CT findings in a case of primary pulmonary DLBCL.
• To emphasize the importance of recognizing ¹⁸F-FDG PET/CT patterns suggestive of DLBCL presenting as diffuse ground-glass opacities (GGO).

Main Methods:

• A case study of a 72-year-old male with progressive respiratory symptoms.
• Initial and follow-up computed tomography (CT) and ¹⁸F-FDG PET/CT imaging.
• CT-guided lung core biopsy for histopathological diagnosis.

Main Results:

• Initial CT and ¹⁸F-FDG PET/CT showed non-specific dependent GGO.
• Repeat imaging revealed progression of lung abnormalities.
• Histopathology confirmed primary pulmonary DLBCL.

Conclusions:

• Primary pulmonary DLBCL can manifest with diffuse GGO on ¹⁸F-FDG PET/CT.
• This presentation is a unique finding that can mimic other pulmonary conditions.
• Early identification of these ¹⁸F-FDG PET/CT findings is critical for prompt diagnosis and management of pulmonary DLBCL.