Gelatinous Degeneration of the Bone Marrow Mimicking Osseous Metastasis on 18F-FDG PET/CT

Chong, Ari; Song, Ho‐Chun; Oh, Jong-Ryool; Ha, Jung‐Min; Min, Jung‐Joon; Bom, Hee‐Seung; Choi, Yoo‐Duk; Lee, Ji Shin

doi:10.1097/rlu.0b013e31825ae455

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…Multiple studies have tried to overcome this problem by using follow-up FDG-PET scans as part of their reference standard and considering FDG-avid bone marrow lesions at baseline as true-positive when these lesions disappear during or after therapy. However, benign bone marrow lesions and even active physiological red marrow may also show (either focally or diffusely) increased bone marrow FDG uptake that can decline after therapy [36,[40][41][42][43][44][45][46]. Thus, follow-up FDG-PET examinations may not be reliable for this purpose.…”

Section: Bone Marrow Fdg-petmentioning

confidence: 98%

Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma

2015

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Bone marrow involvement in lymphoma may have prognostic and therapeutic consequences. Bone marrow biopsy (BMB) is the established method for the evaluation of the bone marrow. (18)F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) plays an important role in lymphoma staging, but its value in the assessment of the bone marrow and whether it can replace BMB is still a topic of debate and investigation. The purpose of this scientific communication is to provide an evidence-based overview about the opportunities and limitations of BMB and FDG-PET in the evaluation of the bone marrow in patients with lymphoma. This article first reviews the basic properties, opportunities and limitations of BMB and bone marrow FDG-PET, and then focuses on the clinical utility of BMB and bone marrow FDG-PET in three major lymphoma subtypes including Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma.

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Section: Bone Marrow Fdg-petmentioning

confidence: 98%

Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma

2015

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“…PET-CT revealed no focal lesion of FDG uptake on scanned images, including the entire vertebral column, which excluded the possibility of malignant conditions in our case. To our knowledge, only one case of gelatinous bone marrow transformation has been reported previously based on PET-CT findings, which showed a poor sensitivity for the detection of gelatinous components (8). Moreover, an investigation of gelatinous transformation of bone marrow has yet to be reported based on simple radiography, CT, MR, and PET-CT images (4,9,10).…”

Section: Discussionmentioning

confidence: 98%

Gelatinous Transformation of Bone Marrow Mimicking Malignant Marrow-Replacing Lesion on Magnetic Resonance Imaging in a Patient without Underlying Devastating Disease

Yoo

Lee

Kim

et al. 2018

Investig Magn Reson Imaging

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Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.

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“…FDG uptake is also detected in healthy tissue or benign lesions in cases of inflammation or posttraumatic repair and could be mistakenly interpreted as representing cancer [ 13 ]. Examples of PET-positive benign diseases that mimic malignant tumors are suture granuloma [ 14 ], carbon particle-induced granuloma [ 15 ], food residue granuloma [ 16 ], breast implant foreign bodies [ 17 ], hepatic focal fat [ 18 ], inflammatory pseudotumor [ 19 ], gelatinous degeneration of the bone [ 20 ], fibrous dysplasia of the bone [ 21 ], and vaginal gauze packing [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

An FDG-PET/CT-Positive Lesion Mimicking Local Recurrence of Colon Cancer 5 Years after Radical Colectomy

et al. 2015

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Patient: Female, 75Final Diagnosis: False positive findingsSymptoms: —Medication: —Clinical Procedure: —Specialty: SurgeryObjective:Mistake in diagnosisBackground:Radical resection of colorectal cancer yields satisfactory results. Even if the cancer recurs, long-term survival is expected through further surgical resection of the recurrent disease. For early detection of recurrent lesions, we routinely perform periodic blood tests and imaging studies, in which 18F-fluorodeoxyglucose-glucose positron emission tomography (FDG-PET) plays an important role, for lesion differentiation. We encountered a case of a benign lesion, which had been clinically diagnosed as recurrence of resected colon cancer by FDG-PET/computed tomography (CT).Case Report:A 69-year-old woman underwent radical resection of stage II sigmoid colon cancer. Five years after the operation, local recurrence was suspected on the basis of follow-up CT examination findings. Since the standardized uptake value (SUV) on FDG-PET/CT was 13.3, we diagnosed the lesion as a postoperative local recurrence and performed surgical resection of the lesion. The lesion was conclusively diagnosed as benign fatty tissue, including a fibrovascular component, by histopathological examination.Conclusions:FDG-PET is a very useful technique for differentiating benign from malignant disease. In colorectal cancer, FDGPET not only enables the differentiation of malignancy in the primary tumor, but also the confirmation of metastasis and postoperative recurrence. However, even if the SUV is high, as in the presented case, the lesion may eventually be diagnosed as benign. Therefore, further advances in the PET technique are expected along with the development of more useful modalities.

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Gelatinous Degeneration of the Bone Marrow Mimicking Osseous Metastasis on 18F-FDG PET/CT

Cited by 6 publications

References 8 publications

Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma

Opportunities and limitations of bone marrow biopsy and bone marrow FDG-PET in lymphoma

Gelatinous Transformation of Bone Marrow Mimicking Malignant Marrow-Replacing Lesion on Magnetic Resonance Imaging in a Patient without Underlying Devastating Disease

An FDG-PET/CT-Positive Lesion Mimicking Local Recurrence of Colon Cancer 5 Years after Radical Colectomy

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