ABSTRACT
A 29-year-old male with a history of Hodgkin's lymphoma presented for evaluation of response to chemotherapy with positron emission tomography/computed tomography using fluorine-18-fluoro-2-deoxy-d-glucose (18F-FDG PET/CT). Follow-up 18F-FDG PET/CT imaging demonstrated resolution of previously noted FDG avid axillary lymphadenopathy. However, multiple opacities with increased FDG uptake were noted in the lungs bilaterally, which were suspicious for pulmonary infection, including viral pneumonia. The patient tested positive for coronavirus disease 2019 (COVID-19) virus infection by reverse transcription-polymerase chain reaction (RT-PCR). Additional cycles of chemotherapy were delayed until the patient became negative for COVID-19 virus infection on follow-up RT-PCR test 2 weeks later. The patient received two additional cycles of chemotherapy. Follow-up 18F-FDG PET/CT post chemotherapy demonstrated a decrease in the size of the previously seen mediastinal lymphadenopathy, reduction of FDG uptake by the previously seen mediastinal lymphadenopathy, and reduction of FDG uptake by the previously seen pulmonary opacities, at 2 months after COVID-19 diagnosis. The findings of this case report demonstrated the importance of recognition of pulmonary abnormalities caused by COVID-19 pneumonia on 18F-FDG PET/CT imaging for clinical management of patients with lymphoma. [ FROM AUTHOR] Copyright of Molecular & Clinical Oncology is the property of Spandidos Publications UK Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
BACKGROUND COVID-19 has been identified as the cause of the large outbreak of pneumonia in patients in Wuhan with shared history of exposure to the Huanan seafood market; however, there is more to learn about this disease. Some experts report that the virus may have reduced toxicity during transmission, but others say that toxicity does not change during transmission. CASE REPORT In this case series, we report clinical and imaging characteristics of 3 patients (A, B, and C) infected with COVID-19. In an exposure-tracking epidemiological investigation, we found that it is possible that Patient A transmitted the infection to her treating physician, Patient B. Patient B then likely transmitted the infection to her family member, Patient C. From the chest CT studies and clinical characteristics, we postulate that the virulence did not decrease during human-to-human transmission. In previous studies, patients with the virus infection had changes in chest CT; however, we found that during the early stages of this disease, some patients (Patient C) may have normal chest CT scans and laboratory studies. Most importantly, we found that IL-6 levels were highest and lymphocyte count was lowest in those with more severe infection. CONCLUSIONS In this case series, we report the exposure relationship of the 3 patients and found that chest CT scans may not have any changes at the beginning of this disease. Lymphopenia and elevated levels of IL-6 can be found after infection.