ORIGINAL ARTICLE   

Minerva Medica 2021 June;112(3):338-45

DOI: 10.23736/S0026-4806.20.06607-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Post-heart transplantation lymphoproliferative diseases (PTLDs) and the diagnostic role of [18f] FDG-PET/CT

Antonello SICA ¹ ✉, Maria L. DE RIMINI ², Caterina SAGNELLI ³, Beniamino CASALE ⁴, Alessandro SPADA ¹, Alfonso REGINELLI ¹, Cristiano AMARELLI ⁵, Ciro MAIELLO ⁵, Maria P. BELFIORE ¹, Massimiliano CRETA ⁶, Massimo CICCOZZI ⁷,
Evangelista SAGNELLI ⁴, Teresa TROIANI ¹, Salvatore CAPPABIANCA ¹

¹ Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy; ² Diagnostic Service Department, AORN Dei Colli - V. Monaldi, Naples, Italy; ³ Department of Mental Health and Public Medicine, Luigi Vanvitelli University of Campania, Naples, Italy; ⁴ Department of Pneumology and Tisiology, AORN Dei Colli - V. Monaldi, Naples, Italy; ⁵ Department of Heart Surgery and Transplantations AORN Dei Colli - V. Monaldi, Naples, Italy; ⁶ Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Federico II University, Naples, Italy; ⁷ Medical Statistics and Molecular Epidemiology, Campus Bio-Medico University Hospital, Rome, Italy

BACKGROUND: The incidence of cancer is higher in transplant patients than in the normal population, mostly due to the assumption of immunosuppressants able to reduce the possibility of rejection. In addition, immunocompromised patients have a greater susceptibility to EBV, HPV and HIV, infectious agents that by themselves may favor the onset of malignancies. Post-transplant lymphoproliferative diseases (PLDs) are among the most frequent neoplasms in transplant patients which like other aggressive neoplasms may be identified by the [18f] fluoro-D-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT).
METHODS: We evaluated the clinical use of FDG-PET/CT in detecting PTLDs and other neoplasms performed at the lowest clinical or laboratory suspicion of malignancy in 127 consecutive subjects who underwent heart transplantation.
RESULTS: A SUV>4 more confirmed the suspect of malignancy and induced us to further investigations. Of the 127 transplant subjects who underwent FDG-PET/CT, 64 showed a SUV value >4. Of these 64, 8 had PTLDs, 49 other neoplasms (urinary tract tumors, thyroid cancer, HPV cancer related, Kaposi’ sarcoma and EBV related head and neck neoplasms) and 7 patients with chronic non-neoplastic inflammatory diseases.
CONCLUSIONS: In the present study, FDG-PET/CT examination was of great use for an early identification and for an early treatment of PTLDs and other neoplasms.

KEY WORDS: Lymphoproliferative disorders; Fluorodeoxyglucose F18; Heart transplantation