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Year : 2020  |  Volume : 19  |  Issue : 3  |  Page : 281-283

Rapidly lethal secondary hemophagocytic lymphohistiocytosis predicted by fluorodeoxyglucose positron-emission tomography/computed tomography

Department of Radiology and Imaging, Yale University School of Medicine, New Haven, CT, USA

Correspondence Address:
Dr. Darko Pucar
Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.WJNM_73_19

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Secondary hemophagocytic lymphohistiocytosis (sHLH) is a rare disease with either an indolent or aggressive course. A 29-year-old male presented with fever, polyarthralgias, splenomegaly, retroperitoneal adenopathy, and laboratory findings consistent with Epstein–Barr-mediated sHLH. Consistent with a prior survival analysis by Kim et al., splenic maximum standardized uptake value (SUVmax) >2.52 and bone marrow SUVmax>3.13 on18F-fuorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) predicted an aggressive disease with poor treatment response. Despite optimal treatment, the patient rapidly progressed to death within 3 months of symptom onset. This case underscores the potential lethal nature of sHLH, and the evolving role of18FDG-PET/CT in predicting disease severity and treatment response.

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