The Teaching Point

It can be challenging to stage and monitor an indolent disease such as MALT lymphoma, which can sometimes present in multiple sites, anywhere in the body, and can relapse at distant locations years after completion of local treatment. Staging of patients with MALT lymphoma and the use of a whole-body scanning protocols covering vertex to feet, when FDG PET/CT scan is being utilized, is recommended to accurately determine optimized treatment approaches.






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From the manuscript

The use of whole-body fluorine-18-fluorodeoxyglucose positron emission tomography integrated with computed tomography for accurate staging and surveillance in the case of mucosa-associated lymphoid tissue

Free full text article: The use of whole-body fluorine-18-fluorodeoxyglucose positron emission tomography integrated with computed tomography for accurate staging and surveillance in the case of mucosa-associated lymphoid tissue

Abstract
We present the case of a 79-year-old male, who was initially treated for mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the right eyelid, and later for disease relapse in the stomach. During follow up, he was noted to have developed left arm nodules just medial to the proximal biceps muscle, which were found to be multiply enlarged lymph nodes on subsequent ultrasound imaging. Excisional biopsy of these nodes revealed MALT lymphoma. He was initially referred for consideration of radiation, but a restaging F-18 fluorodeoxyglucose positron emission tomography integrated with computed tomography (F-18 FDG PET/CT) further identified a focus of suspicious uptake in left calf, which was later also biopsy proven to be MALT lymphoma. His disease was upstaged as the result of this later finding, and the overall recommendation for treatment changed to favor systemic treatment with Rituximab.






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1. Extranodal marginal zone B-cell lymphoma

2. mucosa-associated lymphatic tissue (MALT) lymphoma

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4. field of view

5. PET/CT


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