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Richter Syndrome Presenting With Colon Localization

Lavalle, Mariadea, MD*; Minordi, Laura Maria, MD; Hohaus, Stefan, MD; Manfredi, Riccardo, MD§; Rufini, Vittoria, MD

doi: 10.1097/RLU.0000000000002393
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A 75-year-old man, who had been diagnosed with small lymphocytic lymphoma with cervical localization, underwent 18F-FDG PET/CT with iodinated contrast medium due to the appearance of cervical swelling suspected of illness relapse. PET/CT revealed intense 18F-FDG uptake in multiple cervical and subdiaphragmatic lymph nodes and in the left parotid. Moreover, diffuse uptake and wall thickening of the colon were evident; endoscopy with biopsy revealed a diffuse large B-cell lymphoma. Transformation into a more aggressive lymphoma occurs in 2% to 8% of small lymphocytic lymphoma, the so-called Richter syndrome. Extranodal localization in the sigmoid colon is an extremely rare site for transformed lymphoma.

From the *Nuclear Medicine Unit, Ente Ecclesiastico Ospedale Generale Regionale “F. Miulli,” Acquaviva delle Fonti, Bari;

Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS;

Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Istituto di Ematologia;

§Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Istituto di Radiologia; and

Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Istituto di Medicina Nucleare, Fondazione Policlinico Universitario A. Gemelli IRCCS–Università Cattolica del Sacro Cuore, Rome, Italy.

Received for publication April 24, 2018; revision accepted October 13, 2018.

Conflict of interest and sources of funding: none declared.

Correspondence to: Mariadea Lavalle, MD, Nuclear Medicine Unit, Ente Ecclesiastico Ospedale Generale Regionale “F. Miulli,” S.P. 127 Acquaviva/Santeramo Km. 4100, 70021 Acquaviva delle Fonti, Bari, Italy. E-mail: m.lavalle@miulli.it.

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