Vital Hepatic Lymphoma Residuum or Excessive Immune Response? Challenging Treatment Decisions in a Patient With Systemic Lupus Erythematosus and Liver-Dominant Diffuse Large B-Cell Lymphoma: Case Report

Bibliographic Details
Title: Vital Hepatic Lymphoma Residuum or Excessive Immune Response? Challenging Treatment Decisions in a Patient With Systemic Lupus Erythematosus and Liver-Dominant Diffuse Large B-Cell Lymphoma: Case Report
Authors: Lars Kurch, Thomas W. Georgi, Astrid Monecke, Daniel Seehofer, Gudrun Borte, Osama Sabri, Regine Kluge, Simone Heyn, Matthias Pierer, Uwe Platzbecker, Sabine Kayser
Source: Frontiers in Oncology, Vol 11 (2022)
Publisher Information: Frontiers Media S.A., 2022.
Publication Year: 2022
Collection: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Subject Terms: DLBCL, 18F-FDG-PET/CT, immunoresponse, systemic lupus eryhematosus, interdisciplinary approach, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
More Details: A 28-year-old female patient with active and difficult-to-treat systemic lupus erythematosus (SLE) was diagnosed with liver-dominant diffused large B-cell lymphoma. Repeated response 18F-FDG-PET studies showed persistently high, and, despite intensified immunochemotherapy, further increasing metabolic activity of one of the hepatic lymphoma residuals, whereas all other initial lymphoma manifestations had achieved complete metabolic remission. As biopsy of the 18F-FDG-PET-positive liver residual turned out to be inconclusive, complete resection was performed. Subsequent histopathological examination, however, revealed only necrotic tissue. Thus, no further lymphoma treatment was scheduled. The patient undergoes regular surveillance and is disease-free 13 months after resection. Similarly, treatment of SLE is no longer required due to lack of activity already after the first two cycles of lymphoma treatment. The case shows how closely SLE and diffused large B-cell lymphoma can be connected and stresses the importance of interdisciplinary treatment approaches. In the future, artificial intelligence may help to further classify 18F-FDG-PET-positive lymphoma residuals. This could lead to an increase of the positive predictive value of interim- and end-of-treatment 18F-FDG-PET. The patient’s point of view enables another instructive perspective on the course of treatment, which often remains hidden to treating physicians due to lack of time in clinical routine.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2234-943X
Relation: https://www.frontiersin.org/articles/10.3389/fonc.2021.798757/full; https://doaj.org/toc/2234-943X
DOI: 10.3389/fonc.2021.798757
Access URL: https://doaj.org/article/0055d65b3eed493da221e15ae6b617f8
Accession Number: edsdoj.0055d65b3eed493da221e15ae6b617f8
Database: Directory of Open Access Journals
More Details
ISSN:2234943X
DOI:10.3389/fonc.2021.798757
Published in:Frontiers in Oncology
Language:English