What’s the Diagnosis – Case 116
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What’s the Diagnosis – Case 116
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Findings The PET CT study demonstrates multiple destructive lesions scattered throughout the skeleton that demonstrate a marked degree of increased FDG activity manifest by the bright signal on the fusion images. The MRI exams then show multiple lesions of the bone with a particularly massively destructive lesion centered about the left glenoid. In only a couple of months interval on the CT study, there is a dense and somewhat irregular left glenoid but an otherwise remarkable reconstitution of the bone.
What’s the Diagnosis – Case 116
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Diagnosis: Post Chemotherapy changes in the setting of B Cell Lymphoma The multiple destructive, FDG avid lesions is typical of a metastatic process but otherwise nonspecific. The striking finding in this case is that the patient finished their chemotherapy regimen only three months prior to the 12/2017 CT study in 9/2017. This rapid reconstitution of bone is a well known phenomenon, emphasizing the amazing healing potential of the human body as the glenoid albeit slightly abnormal is well reconstituted. The marrow pattern on MRI typically shows marked changes following chemotherapy in those patients who have a good response to treatment. No post treatment MRI exams were available at the time this case presentation was prepared.
Special thanks to Robert Schneider, MD and Douglas Mintz, MD in their assistance in diagnosis and understanding in this case.
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References MR imaging of therapy-induced changes of bone marrow. Heike E. Daldrup-Link,corresponding author Tobias Henning, and Thomas M. Link. Eur Radiol. 2007 Mar; 17(3): 743–761.Published online 2006 Sep 21. doi:10.1007/s00330-006-0404-1 PMCID: PMC1797072
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