CASE REPORT article
Front. Med.
Sec. Nuclear Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1665417
Primary pulmonary lymphoma with CT negative and PET high metabolism combined with hemophagocytic syndrome: A case report
Provisionally accepted
- Affiliated Hospital of Jining Medical University, Jining, China
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Background: Primary pulmonary diffuse large B-cell lymphoma (DLBCL) is usually accompanied by imaging visible lesions. Cases with normal CT morphology and high PET metabolism are extremely rare, especially when combined with hemophagocytic syndrome (HLH). Case: A 50-year-old man presented with fever of unknown origin (FUO) in March. Chest CT showed no abnormalities, while PET / CT showed diffuse hypermetabolism in both lungs (SUVmax 5.1) and slightly increased bone marrow uptake (SUVmax 3.1). Laboratory tests showed a significant increase in ferritin (1132.37 ng / mL) and CRP (115.38 mg / L), and bone marrow smears showed hemophagocytosis. PET metabolic focus targeted lung biopsy confirmed DLBCL (germinal center type). Complete metabolic remission was achieved after 4 cycles of R-CEOP chemotherapy. Conclusion: Primary pulmonary lymphoma (PPL) should be considered in patients with diffuse increased 18F-FDG uptake in both lungs and accompanied by hemophagocytic syndrome when they do not meet the imaging findings of common lung diseases, and the site of increased uptake should be selected for pathological biopsy.
Keywords: Primary pulmonary lymphoma, PET/CT, hemophagocytic lymphohistiocytosis, case, Lung
Received: 14 Jul 2025; Accepted: 21 Aug 2025.
Copyright: © 2025 Dang, Zhao, Wang, Ai, Wang and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Min Du, Affiliated Hospital of Jining Medical University, Jining, China
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