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Hereditary Spherocytosis Presenting as Diffuse Bone Marrow Activation and Splenomegaly on PSMA-Targeted 18F-DCFPyL PET/CT

Gomez, Erin MD*; Tran, Phuoc T. MD, PhD; Pienta, Kenneth J. MD; Pomper, Martin G. MD, PhD*‡; Gorin, Michael A. MD*‡; Rowe, Steven P. MD, PhD*‡

doi: 10.1097/RLU.0000000000002489
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We present the case of a 71-year-old man with Gleason 3 + 3 = 6 pT2N0MxR0 adenocarcinoma of the prostate who presented with rising PSA level 16 years after radical prostatectomy. PSMA-targeted 18F-DCFPyL PET/CT was performed, which demonstrated recurrent disease in the prostatectomy bed as well as splenomegaly and mild-diffuse bone marrow activation, consistent with the patient's history of hereditary spherocytosis. We briefly review the clinical characteristics of hereditary spherocytosis, its appearance on molecular imaging studies, the normal biodistribution of 18F-DCFPyL, and the PSMA-RADS scoring system for characterizing findings on PSMA-targeted PET imaging.

From the *The Russell H. Morgan Department of Radiology and Radiological Science

Department of Radiation Oncology and Molecular Radiation Sciences

The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.

Received for publication December 3, 2018; revision accepted December 25, 2018.

Conflicts of interest and sources of funding: M.G.P. is a coinventor on a US patent covering 18F-DCFPyL and as such is entitled to a portion of any licensing fees and royalties generated by this technology. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. M.A.G. has served as a consultant for Progenics Pharmaceuticals, Inc, the licensee of 18F-DCFPyL. K.J.P., M.G.P., M.A.G., and S.P.R. have received research funding from Progenics Pharmaceuticals, Inc. Funding was received from the Prostate Cancer Foundation Young Investigator Award and National Institutes of Health grants CA134675, CA184228, EB024495, and CA183031.

Correspondence to: Erin Gomez, MD, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N Wolfe St, Central Radiology, Rm 118, Baltimore, MD 21287. E-mail: egomez8@jhmi.edu.

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