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Infect Agent Cancer ; 16(1): 38, 2021 Jun 02.
Article in English | MEDLINE | ID: covidwho-1255945


Patients with non-hodgkin lymphomas (NHL) represent a population of special interest during the current Coronavirus disease-19 (COVID-19) pandemics. NHLs are associated with disease- and treatment-related immunodeficiencies which may generate unusual COVID-19 dynamics and pose unique management challenges. We report the unusual clinical course of COVID-19 in a patient with mantle cell lymphoma (MCL) exposed to nine doses of Rituximab shortly before infection with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). He had a prolonged asymptomatic phase, with negative molecular and antibody testing for SARS-CoV-2, followed by a rapidly progressive evolution to severe COVID-19. Despite detection of viral RNA overlapped with first symptoms occurrence, anti-SARS-CoV-2 antibodies displayed an asynchronous pattern, with IgG first appearing 2 days after RNA positivity and IgM never being detected throughout the entire clinical course. While disease-associated immune derangements and/or previous treatments involving anti-CD20 antibodies might have contributed to COVID-19 dynamics in our patient, data suggests that antibody testings, without concurrent molecular assessment for SARS-CoV-2, may turn inadequate for monitoring of MCL patients, and in general NHL patients heavily exposed to anti-CD20 antibodies, during the current pandemics. We suggest that repeated molecular testing of nasopharyngeal swab should be implemented in these subjects despite a negative serology and absence of symptoms of SARS-CoV-2 infection. For the same reasons, a customized strategy needs to be developed for patients exposed to anti-CD20 antibodies, based on different features and mechanism of action of available SARS-CoV-2 vaccines and novel vaccinomics developments.

Clin Nucl Med ; 46(4): e221-e223, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-944540


ABSTRACT: In accordance with published international COVID-19 pandemic guidance (American College of Nuclear Medicine, British Nuclear Medicine Society, and European Association of Nuclear Medicine), the use of face masks has become an essential part of infection control for both patients and staff. A 56-year-old man with mantle cell lymphoma underwent staging FDG PET/CT, which demonstrated avid lymphadenopathy below the diaphragm and an unusual diffuse FDG uptake projected over the face, raising the suspicion of cutaneous lymphomatous involvement. On reflection of the clinical scenario and scanning conditions, cutaneous involvement was discounted; the pattern of uptake and lack of CT correlate were supportive of a cutaneous artifact related to the presence of the patient's mask.

COVID-19/prevention & control , Skin Diseases/diagnostic imaging , Artifacts , Fluorodeoxyglucose F18 , Humans , Infection Control , Lymphoma/diagnostic imaging , Male , Masks , Middle Aged , Positron Emission Tomography Computed Tomography , SARS-CoV-2
Clin Nucl Med ; 45(7): e305-e306, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-396362


A 52-year-old woman with no medical history was admitted on March 18, 2020, presenting since 3 days asthenia, abdominal pain, and dry cough but no fever. Adenomegalies, splenomegaly, leukocytosis, and elevated LDH suggested mature lymphoproliferation. Considering the current health context, an RT-PCR testing for COVID-19 (coronavirus disease 2019) was performed and found to be positive. Early chest CT showed no sign of pulmonary infection but multiple adenomegalies. An F-FDG PET/CT performed 5 days later to assess the extent of the hemopathy revealed the apparition of FDG-avid bilateral ground glass and subpleural curvilinear opacities suggesting COVID-19-associated pneumopathy.

Coronavirus Infections/diagnostic imaging , Lymphoma, Mantle-Cell/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Positron Emission Tomography Computed Tomography , Adult , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/pathology , Female , Fluorodeoxyglucose F18 , Humans , Lung/diagnostic imaging , Lung/pathology , Lymphoma, Mantle-Cell/complications , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/pathology , Radiopharmaceuticals