Case Report
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World J Gastroenterol. May 7, 2014; 20(17): 5141-5146
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5141
18F-FDG PET/CT imaging for a gastrointestinal mantle cell lymphoma with multiple lymphomatous polyposis
Makoto Saito, Masaya Miyazaki, Mishie Tanino, Shinya Tanaka, Kencho Miyashita, Koh Izumiyama, Akio Mori, Tatsuro Irie, Masanori Tanaka, Masanobu Morioka, Eriko Tsukamoto
Makoto Saito, Koh Izumiyama, Akio Mori, Tatsuro Irie, Masanori Tanaka, Masanobu Morioka, Department of Internal Medicine and Hematology, Aiiku Hospital, Sapporo 064-0804, Japan
Masaya Miyazaki, Mishie Tanino, Shinya Tanaka, Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
Kencho Miyashita, Department of Gastroenterology, Aiiku Hospital, Sapporo 064-0804, Japan
Eriko Tsukamoto, Department of Nuclear Medicine, Central CI Clinic, Sapporo 060-0042, Japan
Author contributions: Saito M, Izumiyama K, Mori A, Irie T, Tanaka M and Morioka M collected the patient’s clinical data; Saito M and Miyashita K analyzed the endoscopic features; Tsukamoto E interpreted the 18F-FDG PET/CT imaging; Miyazaki M, Tanino M and Tanaka S performed the pathological analyses including evaluation of the Ki-67 proliferative index; Saito M designed and wrote the report.
Supported by Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
Correspondence to: Makoto Saito, MD, PhD, Department of Internal Medicine and Hematology, Aiiku Hospital, Chuo-ku, Minami 4 Nishi 25, Sapporo 064-0804, Japan. ikyoku@aiiku-hp.or.jp
Telephone: +81-11-5632211 Fax: +81-11-5221691
Received: October 12, 2013
Revised: January 10, 2014
Accepted: March 7, 2014
Published online: May 7, 2014
Processing time: 206 Days and 18.9 Hours
Abstract

Multiple lymphomatous polyposis (MLP) is an uncommon type of gastrointestinal lymphoma characterized by the presence of multiple polyps along the gastrointestinal tract. Most of this entity is in fact considered the counterpart of gastrointestinal tract involvement for mantle cell lymphoma (MCL). To our knowledge, there have been no reports on [fluorine-18]-fluorodeoxy-glucose (18F-FDG)-positron emission tomography (PET)/computed tomography (CT) imaging for gastrointestinal MCL with MLP. We present the results of 18F-FDG PET/CT imaging in a patient with gastrointestinal tract involvement of MCL showing continuous MLP from the stomach to the rectum and intestinal intussusception. FDG-PET/CT findings were false negative in typical MLP spreading widely over the gastrointestinal tract, but uptake was noted in large lesions with deep infiltration considered atypical as MLP. On FDG-PET/CT imaging, the Ki-67 proliferative index, which is a cell proliferation marker, showed neither correlation with the presence of uptake nor the maximum standardized uptake value.

Keywords: 18F-fluorodeoxy-glucose-positron emission tomography/computed tomography imaging; Mantle cell lymphoma; Multiple lymphomatous polyposis; Gastrointestinal tract; Ki-67 proliferative index

Core tip: To the present, there have been no reports on [fluorine-18]-fluorodeoxy-glucose (18F-FDG)-positron emission tomography (PET)/computed tomography (CT) imaging of gastrointestinal mantle cell lymphoma (MCL) with multiple lymphomatous polyposis (MLP). In this report, we present the results of 18F-FDG PET/CT imaging in such a MCL patient showing continuous MLP from the stomach to the rectum. We also compared FDG-PET/CT imaging with the Ki-67 proliferative index, an index of cell proliferation, and found that their relationship was inconsistent. The findings of FDG-PET/CT were false negative in typical MLP, but uptake was noted in larger lesions with deep infiltration considered atypical MLP, regardless of the Ki-67 proliferative index.