GA-67 UPTAKE IN A MASS OF BENIGN TRANSFORMATION MIMICKING RECURRENCE OF NODULAR LYMPHOCYTIC PREDOMINANCE HODGKINS-DISEASE

Gallium-67 is now widely used in the management of lymphoma patients. It is not, however, tumor-specific and reasons for uptake in nonmalign ant and premalignant lesions associated with lymphoma should be recogn ized. Gallium-67 uptake in a mass of progressively transformed germina l centers and sarcoid-like reaction, mimicking recurrence in a 31-yr-o ld man with nodular lymphocytic predominance Hodgkin's disease, is des cribed. Gallium-67 was taken up on two occasions and a recurrence was suspected. On the first occasion, abnormal uptake was present in axill ary lymph nodes and on the second in mediastinal and parahilar lymph n odes. Histology of the lesions on both occasions showed progressively transformed germinal centers and sarcoid-like reaction but no evidence of Hodgkin's disease (HD). Bilateral parahilar abnormal uptake of Ga- 67 disappeared spontaneously without treatment after several months. T he mass on CT regressed but did not disappear. This case demonstrates that the appearance of a new mass which takes up Ga-67 in lymphocytic- predominance HD during a continuous clinical remission does not necess arily indicate recurrence and the need for treatment. It suggests that a biopsy should be performed to determine the nature of the lesion.