Significant Contribution of <i>Fluorodeoxyglucose</i> Positron Emission Tomography/Computed Tomography (FDG PET/CT) in a Case of Acute Lymphoblastic Leukemia Presenting with Fever of Unknown Origin

Abstract

The diagnostic value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has not been thoroughly evaluated in patients with leukemia. We herein report the case of a patient with B cell acute lymphoblastic leukemia (ALL) presenting with fever of unknown origin (FUO) who was diagnosed after FDG PET/CT indicated diffuse bone marrow involvement.

The value of ¹⁸F‑FDG PET/CT in the prediction of clinical outcomes of patients with acute leukemia treated with allogeneic hematopoietic stem cell transplantation

“…Since AL is a hematological malignancy that originates from BM, increased BM uptake of 18 F-FDG can be observed in patients with AL (24). However, increased BM 18 F-FDG uptake can also be observed in benign etiologies and other types of malignant infiltration (25,26).…”

Sacroilitis paraneoplásica: presentación inusual de leucemia linfoblástica aguda

“…El papel de la PET con 18 FDG en el abordaje de las leucemias agudas se encuentra documentado en el diagnóstico temprano de aquellos casos con presentaciones atípicas, como pacientes con leucemias aleucémicas, aquellos con incapacidad para obtener un aspirado de medula ósea o en presencia de fiebre de origen desconocido 12,13 . En nuestro caso, fue fundamental para llegar al diagnóstico.…”

Increased bone marrow uptake of 18F-FDG in leukemia patients: preliminary findings

“…In this study, the time from the detection of the first symptoms to the diagnosis was longer in the 3 patients without than in the 6 patients with leukemic cells in the peripheral blood. In such cases, imaging modalities such as magnetic resonance (Bartakke et al 2007 ; Kato et al 2011 ) and PET/CT (Ennishi et al 2009 ; Su et al 2013 ; Arslan et al 2014 ) may enable the earlier detection of BM abnormalities and thus an earlier initiation of treatment (Derlin et al 2011 ). In fact, PET/CT is of greater utility than MRI because it can easily scan the whole body.…”

“…Although 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) or 18F-FDG PET/computed tomography (CT) is widely used for the diagnosis, staging, and response assessment of various types of malignancy, it is not routinely used in patients with leukemia, because leukemia typically does not present with a solid tumor, and because clinical use of this investigation in patients with leukemia has only been described in few case reports (Takalkar et al 2004 ; Rao et al 2009 ; Takahashi et al 2011 ; Su et al 2013 ; Arslan et al 2014 ; Parida et al 2015 ). We previously reported a case of acute lymphoblastic leukemia associated with diffuse homogeneous BM uptake of 18F-FDG (Su et al 2013 ), indicating that some patients with leukemia who have tumor cells in the BM aspirate also have increased BM uptake of 18F-FDG on PET/CT.…”