Topic Editors

ASST Spedali Civili Brescia, University of Brescia, Brescia, Italy
1. Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
2. Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland

Lymphoma: Update on the Role of Imaging in the Understanding, Diagnosis, Treatment and Management

Abstract submission deadline
closed (20 March 2023)
Manuscript submission deadline
closed (20 May 2023)
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Topic Information

Dear Colleagues,

Lymphomas are cancers of the lymphatic system, which is a part of the body’s germ-fighting network. They include Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). There are more than 30 unique types of lymphoma, each with a peculiar and distinct natural history. This biological heterogeneity gives rise to marked differences with respect to epidemiological, pathological, clinical and imaging findings.

An accurate assessment of the stage of disease seems to be crucial for the selection of the appropriate therapy. Imaging techniques, such as PET/CT, MRI and CT, are used for the diagnosis, the evaluation of the extension of disease, treatment response evaluation and prognostication. 18F-FDG PET/CT is considered the gold standard for FDG-avid lymphoma variants (HL, DLBCL and FL), despite recent evidence that underlines a potential usefulness of other variants, such as MCL and BL. CT and MRI are recommended when the role of PET is limited.

The technological evolution with the introduction of new scanners (PET/MRI, digital PET or total PET), radio-tracers (Ga68-Pentixafor) or image analysis techniques (texture analysis) may have a huge impact in the future.

The aim of this Special Issue is to discuss the current and future clinical applications of imaging tools in the study of lymphoma, with a focus on diagnosis, treatment response evaluation and prognostication.

Dr. Domenico Albano
Prof. Dr. Giorgio Treglia
Topic Editors

Keywords

  • lymphoma
  • PET/CT
  • nuclear medicine
  • imaging
  • MR
  • CT
  • diagnosis
  • therapy
  • prognosis

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Cancers
cancers
5.2 7.4 2009 17.9 Days CHF 2900
Diagnostics
diagnostics
3.6 3.6 2011 20.7 Days CHF 2600
Journal of Clinical Medicine
jcm
3.9 5.4 2012 17.9 Days CHF 2600
Medicina
medicina
2.6 3.6 1920 19.6 Days CHF 1800
Tomography
tomography
1.9 2.3 2015 24.5 Days CHF 2400

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Published Papers (7 papers)

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8 pages, 2918 KiB  
Case Report
Primary Effusion Lymphoma, Multicentric Castleman’s Disease, and Kaposi’s Sarcoma in an HHV-8 and HIV-Positive Patient: A Case Report
by Juan Carlos Caballero, Laura Pardo, Maria Socorro Rodriguez-Pinilla, Miguel Angel Piris, Beatriz Alvarez, Laura Solan, Javier Cornago, Jose Luis Lopez-Lorenzo, Pilar Llamas, Raul Cordoba and Alberto Lopez-Garcia
Medicina 2023, 59(6), 1049; https://doi.org/10.3390/medicina59061049 - 30 May 2023
Viewed by 1306
Abstract
Primary effusion lymphoma (PEL), Kaposi’s sarcoma (KS), and multicentric Castleman’s disease (MCD) is an uncommon group of diseases included in the same spectrum with related characteristics. The coexistence of all of them in the same individual is a rare occurrence. We present the [...] Read more.
Primary effusion lymphoma (PEL), Kaposi’s sarcoma (KS), and multicentric Castleman’s disease (MCD) is an uncommon group of diseases included in the same spectrum with related characteristics. The coexistence of all of them in the same individual is a rare occurrence. We present the case of a 25-year-old patient diagnosed with human immunodeficiency virus (HIV) and the development of all these related pathologies. Despite the use of intensive treatment according to the latest recommendations, the evolution was unfavorable. This case reflects the need for new therapies and research in this field. Full article
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14 pages, 305 KiB  
Article
Antiapoptotic Gene Genotype and Allele Variations and the Risk of Lymphoma
by Osama M. Al-Amer, Rashid Mir, Abdullah Hamadi, Mohammed I. Alasseiri, Malik A. Altayar, Waseem AlZamzami, Mamdoh Moawadh, Sael Alatawi, Hanan A. Niaz, Atif Abdulwahab A. Oyouni, Othman R. Alzahrani, Hanan E. Alatwi, Aishah E. Albalawi, Khalaf F. Alsharif, Ashraf Albrakati and Yousef M. Hawsawi
Cancers 2023, 15(4), 1012; https://doi.org/10.3390/cancers15041012 - 05 Feb 2023
Cited by 1 | Viewed by 1677
Abstract
Background: The findings of earlier investigations of antiapoptotic gene genotypes and allele variants on lymphoma risk are ambiguous. This study aimed to examine the relationship between the mutation in the antiapoptotic genes and lymphoma risk among Saudi patients. Methods: This case–control study included [...] Read more.
Background: The findings of earlier investigations of antiapoptotic gene genotypes and allele variants on lymphoma risk are ambiguous. This study aimed to examine the relationship between the mutation in the antiapoptotic genes and lymphoma risk among Saudi patients. Methods: This case–control study included 205 patients, 100 of whom had lymphoma (cases) and 105 who were healthy volunteers (controls). We used tetra amplification refractory mutation polymerase chain reaction (PCR) to identify antiapoptotic genes such as B-cell lymphoma-2 (BCL2-938 C > A), MCL1-rs9803935 T > G, and survivin (BIRC5-rs17882312 G > C and BIRC5-rs9904341 G > C). Allelic-specific PCR was used to identify alleles such as BIRC5-C, MCL1-G, and BIRC5-G. Results: The dominant inheritance model among cases showed that mutations in all four antiapoptotic genes were more likely to be associated with the risk of lymphoma by the odds of 2.0-, 1.98-, 3.90-, and 3.29-fold, respectively, compared to controls. Apart from the BCL-2-A allele, all three specified alleles were more likely to be associated with lymphoma by the odds of 2.04-, 1.65-, and 2.11-fold, respectively. Conclusion: Unlike healthy individuals, lymphoma patients are more likely to have antiapoptotic gene genotypes and allele variants, apart from BCL-2-A alterations. In the future, these findings could be used to classify and identify patients at risk of lymphoma. Full article
13 pages, 2699 KiB  
Article
Anti-PD1 Consolidation in Patients with Hodgkin Lymphoma at High Risk of Relapse after Autologous Stem Cell Transplantation: A Multicenter Real-Life Study
by Rosaria De Filippi, Gianpaolo Marcacci, Enrico Derenzini, Maurizio Musso, Daniela Donnarumma, Emanuela Morelli, Caterina Patti, Alessio Maria Edoardo Maraglino, Renato Scalone, Luigia Simeone, Cristina Becchimanzi, Sara Mele, Stefania Crisci, Fortunato Morabito and Antonio Pinto
Cancers 2022, 14(23), 5846; https://doi.org/10.3390/cancers14235846 - 27 Nov 2022
Cited by 2 | Viewed by 1725
Abstract
(1) Background: Consolidation therapy is an emerging strategy for patients with relapsed/refractory (RR) Hodgkin Lymphoma (HL) at high risk of failing salvage autologous stem cell transplantation (ASCT). (2) Objectives: To assess the safety and effectiveness of PD1-blockade consolidation for these high-risk patients. (3) [...] Read more.
(1) Background: Consolidation therapy is an emerging strategy for patients with relapsed/refractory (RR) Hodgkin Lymphoma (HL) at high risk of failing salvage autologous stem cell transplantation (ASCT). (2) Objectives: To assess the safety and effectiveness of PD1-blockade consolidation for these high-risk patients. (3) Design: Multi-center retrospective analysis. (4) Methods: We identified 26 patients given anti-PD1 consolidation, from June 2016 to May 2020. (5) Results: Patients displayed the following risk factors: refractory disease (69%), relapse < 12 months from upfront therapy (15%), ≥2 lines of salvage therapy (73%), extranodal disease (65%). Nineteen patients (73%) had ≥3 of these factors. In addition, 16 patients (61%) also displayed PET-positive (Deauville ≥ 4) disease before ASCT. Treatment-related adverse events (TRAEs), never graded > 3, occurred in 12 patients (46.15%) and mainly included skin rashes (41.7%), transaminitis (33.3%), and thyroid hypofunction (25%). Patients completed a median of 13 courses (range 6–30). At a median follow-up of 25.8 months post-ASCT, the median progression-free (PFS) was 42.6 months, with a 2-year PFS and overall survival rates of 79% and 87%, respectively. (6) Conclusions: Post-ASCT consolidation with anti-PD1 is feasible and effective. Further studies are warranted to define the optimal treatment length and patients’ subsets more likely to benefit from this approach. Full article
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9 pages, 18960 KiB  
Case Report
Surgical, Dermatological and Morphopathological Considerations in the Diagnosis and Treatment of Cutaneous Lymphoproliferative Tumors, Primary CD4+
by Valeriu Ardeleanu, Lavinia-Alexandra Moroianu, Anca Sava, Tiberiu Tebeica, Radu Cristian Jecan, Marius Moroianu and Alin Laurentiu Tatu
Medicina 2022, 58(11), 1618; https://doi.org/10.3390/medicina58111618 - 10 Nov 2022
Cited by 1 | Viewed by 2012
Abstract
Primary cutaneous lymphomas are a heterogeneous group of T-cell (CTCL) and B-cell lymphomas (CBCL) developing in the skin and without signs of extracutaneous disease at the time of diagnosis. The term “primary small/medium CD4+ T-cell lymphoma” was changed to “primary small/medium cutaneous CD4+ [...] Read more.
Primary cutaneous lymphomas are a heterogeneous group of T-cell (CTCL) and B-cell lymphomas (CBCL) developing in the skin and without signs of extracutaneous disease at the time of diagnosis. The term “primary small/medium CD4+ T-cell lymphoma” was changed to “primary small/medium cutaneous CD4+ lymphoproliferative disorder” due to its indolent clinical behavior and uncertain malignant potential. This paper presents a rare case of primary cutaneous lymphoma with small to medium CD4+ T-cells. A 37-year-old patient presented with a tumor in the frontal region that had occurred approximately 8–9 months earlier. The tumor had a diameter of about 8–9 mm, well demarcated macroscopically, it was round in shape, about 6–7 mm high, pink in color, firm in consistency and painless during palpation. Surgical excision of the tumor was performed with a margin of safety of 8 mm and deep to the level of the frontal muscle fascia. The histopathological examination supported the diagnosis of cutaneous lymphoproliferation with a nodular disposition in the reticular dermis and extension around the follicular epithelia and sweat glands, composed mainly of dispersed medium-large lymphocytes. Additional immunohistochemical examination was requested. Immunohistochemical examination confirmed the diagnosis of “primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder.” Patient monitoring was carried out through clinical dermatological controls at 3, 6, and 12 months. After one year, a cranio-cerebral MRI was performed. For the following 5 years, an annual dermatological examination accompanied by cranio-cerebral MRI, blood count, and pulmonary X-ray were recommended. Similarly to all solitary skin lesions, the prognosis is excellent in this case, the only treatment being surgical excision. Full article
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14 pages, 1218 KiB  
Article
Longitudinal Body Composition Changes Detected by [18F]FDG PET/CT during and after Chemotherapy and Their Prognostic Role in Elderly Hodgkin Lymphoma
by Domenico Albano, Francesco Dondi, Giorgio Treglia, Alessandra Tucci, Marco Ravanelli, Davide Farina and Francesco Bertagna
Cancers 2022, 14(20), 5147; https://doi.org/10.3390/cancers14205147 - 20 Oct 2022
Cited by 5 | Viewed by 1643
Abstract
The aim of this retrospective study was to investigate the longitudinal body changes in terms of muscle and adipose areas and their prognostic role in elderly (>65 years) patients affected by Hodgkin lymphoma (HL). Skeletal muscle area (SMA), skeletal muscle index (SMI), visceral [...] Read more.
The aim of this retrospective study was to investigate the longitudinal body changes in terms of muscle and adipose areas and their prognostic role in elderly (>65 years) patients affected by Hodgkin lymphoma (HL). Skeletal muscle area (SMA), skeletal muscle index (SMI), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), intramuscular adipose tissue (IMAT), and total dispose tissue (TAT) were measured using the computed tomography (CT) of fluorine-18-fluorodeoxyglucose positron emission tomography/CT ([18F]FDG PET/CT) in 88 patients who undertook baseline, interim (after two cycles of chemotherapy), and end-of-treatment (after 6 cycles of chemotherapy) PET/CT scans. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured at pre-treatment PET/CT. Metabolic response applying Deauville score was evaluated at interim and end-of-treatment PET/CT. Survival curves, such as progression free survival (PFS) and overall survival (OS), were calculated for the whole population. Fifty-eight (66%) patients had sarcopenia at baseline and sarcopenia rate increased at interim scan with 68 (77%) cases and at end-of-treatment scan with 73 (83%) cases. Muscular areas (SMA and SMI) declined significantly during the treatment (p < 0.001), decreasing from baseline by 5% and 7% at interim and end-of-treatment evaluation, respectively. Instead, VAT, SAT, IMAT, and TAT increased significantly over this time (p < 0.001). Sarcopenia was significantly related with comprehensive geriatric assessment. PET/CT response at interim and end-of-treatment, MTV, TLG, and baseline sarcopenia were independent prognostic factors for PFS. Instead, metabolic response at interim and end-of-treatment PET, baseline sarcopenia, ΔSMI at interim, and ΔSMI at end-of-treatment for OS were independent prognostic factors. Full article
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9 pages, 1885 KiB  
Article
Evaluation of the Effects of R-CHOP Chemotherapy on Brain Glucose Metabolism in Patients with Diffuse Large B Cell Lymphoma: A Baseline, Interim, and End-of-Treatment PET/CT Study
by Haiyan Zhu, Fei Li, Yan Chang, Yabing Sun, Nan Wang and Ruimin Wang
Tomography 2022, 8(5), 2565-2573; https://doi.org/10.3390/tomography8050214 - 12 Oct 2022
Viewed by 1705
Abstract
Background: To investigate the effect of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy on brain glucose metabolism in patients with diffuse large B cell lymphoma (DLBCL). Methods: Seventy-two patients with newly diagnosed DLBCL underwent FDG PET/CT brain and whole-body scans at baseline [...] Read more.
Background: To investigate the effect of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy on brain glucose metabolism in patients with diffuse large B cell lymphoma (DLBCL). Methods: Seventy-two patients with newly diagnosed DLBCL underwent FDG PET/CT brain and whole-body scans at baseline (PET0), in the interim of chemotherapy (PET2), and at the end (PET6) of chemotherapy. All three brain scans of each patient were analyzed using statistical parametric mapping software. Results: Compared with the PET0 scan, the PET2 and PET6 scans revealed a significantly higher glucose metabolism throughout the whole brain, with the PET6 scan revealing a higher metabolism than the PET2 scan. Patients with a complete response (CR) displayed decreased glucose metabolism in the lingual gyrus and increased glucose metabolism in the pons after chemotherapy compared with the findings in patients with partial responses or progressive disease. Conclusions: Brain glucose metabolism was affected by R-CHOP treatment throughout the entire chemotherapy protocol. Full article
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12 pages, 593 KiB  
Systematic Review
The Role of [68Ga]Ga-Pentixafor PET/CT or PET/MRI in Lymphoma: A Systematic Review
by Domenico Albano, Francesco Dondi, Francesco Bertagna and Giorgio Treglia
Cancers 2022, 14(15), 3814; https://doi.org/10.3390/cancers14153814 - 05 Aug 2022
Cited by 10 | Viewed by 2417
Abstract
The aim of this systematic review was to investigate published data about the role of gallium-68 Pentixafor positron emission tomography/computed tomography ([68Ga]Ga-Pentixafor PET/CT) or PET/magnetic resonance imaging (PET/MRI) in patients affected by lymphoma. A comprehensive computer literature search of the Scopus, [...] Read more.
The aim of this systematic review was to investigate published data about the role of gallium-68 Pentixafor positron emission tomography/computed tomography ([68Ga]Ga-Pentixafor PET/CT) or PET/magnetic resonance imaging (PET/MRI) in patients affected by lymphoma. A comprehensive computer literature search of the Scopus, PubMed/MEDLINE, and Embase databases was conducted including articles indexed up to June 2022. In total, 14 studies or subsets in studies were eligible for inclusion. From the analyses of the selected studies, the following main findings have been found: (1) lymphomas can be considered [68Ga]Ga-Pentixafor avid diseases, also in cases of fluorine-18 fluorodeoxyglucose [18F]FDG-not avid forms such as lymphoplasmacytic lymphoma (LPL), chronic lymphocytic leukemia (CLL), marginal zone lymphoma (MZL) and central nervous system lymphoma (CNSL); (2) among lymphomas, mantle cell lymphoma (MCL) and MZL are those with highest [68Ga]Ga-Pentixafor uptake; (3) [68Ga]Ga-Pentixafor PET/CT or PET/MRI is a useful tool for the staging and treatment response evaluation; (4) [68Ga]Ga-Pentixafor PET seems to have a better diagnostic performance than [18F]FDG PET in evaluating lymphomas. Despite several limitations affecting this analysis, especially related to the heterogeneity of the included studies, [68Ga]Ga-Pentixafor PET may be considered a useful imaging method for staging and treatment response evaluation of several lymphomas, especially MZL, CNSL and LPL. Full article
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