Key result
FDG-PET/CT detects marked lymphoma progression with rare pericardial recess and rectal involvement post-chemotherapy.
Why the study?
Secondary cardiac lymphoma is a rare manifestation of systemic lymphoma that most commonly involves the pericardium and is typically associated with diffuse large B-cell lymphoma.
Case Report (n=1)
No
This case report highlights the utility of 18F-FDG PET/CT in detecting suspected secondary pericardial and extranodal involvement in early relapsed diffuse large B-cell lymphoma, while emphasizing the need to correlate metabolic imaging findings with clinical and cardiac evaluations.
Answers are grounded in this paper and cite their sources.
PET/CT may aid detection of rare extranodal progression in relapsed DLBCL; hypothesis-generating and should not yet change practice.
Secondary cardiac lymphoma (SCL) is a rare manifestation of systemic lymphoma, most commonly involving the pericardium and typically associated with diffuse large B-cell lymphoma (DLBCL). We report the case of a 75-year-old man with newly diagnosed stage IIIB DLBCL (non-GCB phenotype) who initially achieved complete metabolic remission after R-CHOP chemotherapy. However, early relapse occurred within three months, prompting second-line treatment with R-GEMOX. Follow-up 18F-FDG PET/CT revealed disease progression with intense hypermetabolic activity in mediastinal and hilar lymph nodes, new uptake in the pericardial recess suggestive of pericardial lymphomatous involvement, and suspicious rectal wall involvement. The patient developed worsening dyspnea and rectal bleeding; rectoscopy and subsequent biopsy confirmed lymphomatous infiltration of the rectal wall. This case illustrates the aggressive nature of relapsed DLBCL and the value of metabolic imaging in detecting suspected involvement of uncommon extranodal sites.
No takes yet. Share an insight, caveat, or question.
Nabih et al. (2026) conducted a case report in Relapsed stage IIIB diffuse large B-cell lymphoma (DLBCL, non-GCB phenotype) with suspected secondary pericardial involvement (n=1). 18F-FDG PET/CT following R-CHOP and salvage R-GEMOX immunochemotherapy was evaluated on Metabolic progression and extranodal involvement on 18F-FDG PET/CT. 18F-FDG PET/CT after 2 cycles of R-GEMOX revealed marked metabolic progression (Deauville score 5) with suspected pericardial recess involvement and biopsy-confirmed rectal wall infiltration.
Synapse has enriched 10 related papers. Consider them for comparative context: