18F-Fluoro-2-deoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) is widely used in staging, restaging, and evaluation of treatment response in patients with lymphoma. In this case report, a 59-year-old woman diagnosed with diffuse large B-cell lymphoma (DLBCL) with gallbladder involvement is presented. Immunohistochemical analysis showed strongly positive CD79a, bcl-6, MUM1, bcl-2, and CD43; weakly positive CD20 and CD5 staining; negative c-myc; and Ki-67 of 85%. Interim 18F-FDG PET/CT showed involvement of multiple lymph nodes with high radiopharmaceutical uptake in supra- and infradiaphragmatic lymphatic stations (Figure 1). On the other hand, increased 18F-FDG uptake was observed in newly developed metastatic nodes in addition to previous lesions in the supra/infradiaphragmatic regions on posttreatment PET/CT. Additionally, focal 18F-FDG uptake (dashed arrows) in the upper outer quadrant of the right breast and unexpected gallbladder (GB) wall involvement (arrows) were observed (Figure 2).
Figure 1.
Involvement of multiple lymph nodes with high radiopharmaceutical uptake in supra- and infradiaphragmatic lymphatic stations.
CT: Computed tomography, PET: positron emission tomography, F: fusion, MIP: maximum intensity projection.
Figure 2.
Increased 18F-FDG uptake was observed in newly developed metastatic nodes in addition to previous lesions in the supra/infradiaphragmatic regions on posttreatment PET/CT. Additionally, focal 18F-FDG uptake (dashed arrows) in the upper outer quadrant of the right breast and unexpected gallbladder (GB) wall involvement (arrows) were observed.
CT: Computed tomography, PET: positron emission tomography, F: fusion, MIP: maximum intensity projection.
18F-FDG PET/CT is a diagnostic method for detecting metastatic lesions in GB [1,2,3].Although the involvement of the breasts and thyroid in non-Hodgkin’s lymphoma is frequently reported, involvement of the GB is extremely rare [4,5,6]. Al-Katib et al. [7] detected extranodal involvement of the GB in an 83-year-old male with intravascular large B-cell lymphoma. Bai et al. [8] reported increased 18F-FDG uptake in the GB without luminal pathology in a 15-year-old girl with Hodgkin’s disease.In our case, 18F-FDG PET/CT imaging revealed DLBCL-related involvement in the GB. PET/CT is a useful tool for demonstrating unexpected organ involvements, such as in the GB.
Footnotes
Ethics
Informed Consent: The patient provided verbal and written consent for the use of the medical findings for research purposes.
Authorship Contributions
Surgical and Medical Practices: T.A.; Concept: E.A., T.F.Ç., Design: E.A.; Data Collection or Processing: G.A.; Analysis or Interpretation: T.A., T.F.Ç.; Literature Search: G.A.; Writing: E.A.
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The authors declared that this study received no financial support.
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