Drug-induced pneumonitis detected earlier by F-FDG-PET than by high-resolution CT: a case report with non-Hodgkin's lymphoma

• Published in: Annals of nuclear medicine 2008-10, Vol.22 (8), p.719-722
• Main Authors: Yamane, Tomohiko, Daimaru, Osami, Ito, Satoshi, Nagata, Takeshi, Yoshiya, Kazuhiko, Fukaya, Nobuyuki, Ito, Shinichi, Imai, Teruhiko, Uchida, Hideo
• Format: Article
• Language: English
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-008-0183-7

Drug-induced pneumonitis is a serious and an unpredictable side effect of chemotherapy in patients with malignant lymphoma. We present the case of a 51-year-old man who developed drug-induced pneumonitis during chemotherapy for non-Hodgkin's lymphoma in which pneumonitis was detected earlier by F-fluorodeoxyglucose positron emission tomography (F-FDG-PET) than by high-resolution computed tomography (HRCT). After five courses of chemotherapy, F-FDG-PET was performed for assessing residual lesions, and diffuse lung uptake was incidentally observed. No symptoms were present, and HRCT performed immediately following PET revealed no abnormalities. Mild dyspnea appeared 3 days after PET, and additional HRCT revealed patchy ground-glass opacities disseminated with the appearance of interlobular septum thickening. Drug-induced pneumonitis was finally diagnosed, and treatment was initiated. F-FDG-PET can be an imaging modality for detecting drug-induced pneumonitis at an extremely early stage in which HRCT is incapable of revealing any abnormal changes.