Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Nuclear Medicine

Background:Extra-nodal lymphoma (ENL) is sub group of lymphoma defined as lymphomatous infiltration of anatomical sites other than the lymph nodes or lymphatic tissue. It represents approximately 25-40% of all lymphoma cases. ENL may be primary or secondary. Lymphomas, that initially appear to have the bulk of the disease at extra-nodal sites, are described as a primary ENL while,secondary ENL is described when hematogenous spread of lymphoma from a primary nodal disease to extra-nodal sites and categorized as stage III or IV. F-18 FDG PET/CT) has become the standard imaging tool for initial staging, follow-up, and treatment response assessment in patients with lymphoma as compared to diagnosis CT .However, limited number of studies discusses the role of FDG PET-CT in evaluation of primary or secondary extra-nodal involvement in pediatric lymphoma.Aim of the work:To assess the value of 18-F FDG PET/CT in diagnosis of primary and secondary extra-nodal lymphoma in pediatric age group and to study the potential prognostic role of different metabolic parameters in prognosis of children with ENL. Patients and methods:Prospective study for 90 pediatric patients with pathologically proved lymphoma at extra-nodal site (either primary or secondary extra-nodal involvement) who come to nuclear medicine department at National Cancer Institute for initial assessment. Results:Our study found that initial PET-CT detected many disease involved sites specially bone marrow & spleen with consequent change in disease staging. GIT was the most common affected site with primary ENL, affecting 66.6% & it achieved the best PFS. While, renal and lung lymphomas were the least affected sites with the worst PFS.There was a significant difference in number of relapsed patients between 1ry&2ry ENL

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