case_images: PMC7105614_01
case_images: MRI revealed a heterogeneous enhanced mass lesion with meningeal and adjacent frontal-temporal lobes involvement (A). CT displayed a heterogeneous hyper-intensity mass lesion and peripheral edema (B). 18F-fluorodeoxyglucose (18F-FDG) PET/CT showed intense FDG uptake with SUVmax of 12.0 in the left frontal-temporal lobes. Part of the lesion was naive with FDG uptake (arrows) (C), which could be caused by possible intratumoral hemorrhage. Adjacent skull base bone destruction and extracranial extension to the left infratemporal fossa were also observed. Maximum intensity projection (MIP) view of pretreatment 18F-FDG PET/CT (D) showed the solitary bulky mass. Two consecutive 18F-FDG PET/CT follow-ups (E,F) demonstrated complete remission.
case_images: fonc-10-00334-g0001.jpg
case_images: PMC7105614_01_fonc-10-00334-g0001.jpg
case_images: F1
case_images: MRI revealed a heterogeneous enhanced mass lesion with meningeal and adjacent frontal-temporal lobes involvement (Figure 1A). The mass lesion showed heterogeneous hyperdensity on CT images, and peripheral edema was observed (Figure 1B). 18F-FDG PET/CT showed intense FDG uptake with maximum standardized uptake value (SUVmax) of 12.0 in the left frontal-temporal lobes (Figure 1C). No evident bone marrow (BM) involvement was observed on 18F-FDG PET/CT (Figure 1D). A follow-up 18F-FDG PET/CT scan demonstrated a remarkable metabolism decline of the lesion after the treatment (Figure 1E). After remission, the patient received maintenance therapy with imatinib. A third 18F-FDG PET/CT scan 2-years after initial diagnosis also showed no relapse (Figure 1F).
case_images: Biopsy specimen pathological findings. Hematoxylin and eosin staining revealed diffusely distributed atypical lymphoid cells (A). Immunohistochemical staining showed that the oval-round tumor cells were positive for paired box 5 (PAX5) (B), terminal deoxynucleotidyl transferase (TdT) (C), and CD79a (D). Magnification, x400 for all.
case_images: fonc-10-00334-g0002.jpg
case_images: PMC7105614_01_fonc-10-00334-g0002.jpg
case_images: F2
case_images: Immunohistochemical staining showed that the oval-round tumor cells were positive for paired box 5 (PAX5), terminal deoxynucleotidyl transferase (TdT), and CD79a, which indicated the diagnosis of precursor B-cell lymphoblastic lymphoma (PBLL) (Figure 2).