18F-THK5351 Positron Emission Tomography Clearly Depicted Progressive Multifocal Leukoencephalopathy After Mantle Cell Lymphoma Treatment

Yuta Chiba; Rie Kawakita; Katsuya Mitamura; Kenta Takahashi; Tadaki Suzuki; Kazuo Nakamichi; Kenta Suzuki; Asahiro Morishita; Hideki Kobara; Kazushi Deguchi; Tsutomu Masaki

doi:10.2169/internalmedicine.3023-23

¹⁸F-THK5351 Positron Emission Tomography Clearly Depicted Progressive Multifocal Leukoencephalopathy After Mantle Cell Lymphoma Treatment

Yuta Chiba, Rie Kawakita, Katsuya Mitamura, Kenta Takahashi, Tadaki Suzuki, Kazuo Nakamichi, Kenta Suzuki, Asahiro Morishita, Hideki Kobara, Kazushi Deguchi, Tsutomu Masaki

Author information

Yuta Chiba
Department of Gastroenterology and Neurology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Rie Kawakita
Department of Gastroenterology and Neurology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Katsuya Mitamura
Department of Radiology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Kenta Takahashi
Department of Pathology, National Institute of Infectious Diseases, Japan
Tadaki Suzuki
Department of Pathology, National Institute of Infectious Diseases, Japan
Kazuo Nakamichi
Department of Virology 1, National Institute of Infectious Diseases, Japan
Kenta Suzuki
Department of Neurosurgery, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Asahiro Morishita
Department of Gastroenterology and Neurology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Hideki Kobara
Department of Gastroenterology and Neurology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Kazushi Deguchi
Department of Gastroenterology and Neurology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan
Tsutomu Masaki
Department of Gastroenterology and Neurology, Graduate School of Medicine and Faculty of Medicine, Kagawa University, Japan

Keywords: ¹⁸F-THK5351 PET, progressive multifocal leukoencephalopathy, lymphoma, astrocyte, monoamine oxidase B, JC virus

JOURNAL OPEN ACCESS Advance online publication

Article ID: 3023-23

DOI https://doi.org/10.2169/internalmedicine.3023-23

Details

Abstract

An 84-year-old Japanese woman presented with left hemiplegia 8 months after completing chemotherapy for mantle cell lymphoma. Brain magnetic resonance imaging (MRI) revealed a hyperintense lesion extending from the right parietal lobe to the left parietal lobe. Compared with these MRI results, ¹⁸F-THK5351 PET revealed more extensive accumulation. A brain biopsy showed progressive multifocal leukoencephalopathy (PML). Immunohistochemistry and John Cunningham virus (JCV) DNA-polymerase chain reaction indicated JCV infection. Therefore, a diagnosis of PML was made. ¹⁸F-THK5351 PET, indicative of activated astrocytes, clearly depicted PML lesions composed of reactive and atypical astrocytes. ¹⁸F-THK5351 PET may capture fresh progressive PML lesions better than MRI.

Corresponding author

Register with J-STAGE for free!