Objective: According to recent reports, nodal marginal zone lymphoma (MZL) appears to be a distinctive lymphoma entity rather than a more advanced stage of extranodal MZL of mucosa-associated lymphoid tissue (MALT). We have therefore retrospectively evaluated all patients diagnosed with nodal or extranodal MZL who have been referred to our unit for imaging using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET). Patients and Methods: A total of 21 patients with a diagnosis of MZL upon referral for imaging with 18F-FDG-PET were identified. Histological reassessment of biopsy specimens confirmed the diagnosis of extranodal MZL of MALT in 14 patients, while a diagnosis of nodal MZL was verified in 6 patients. Lymphoma cell proliferation was assessed immunohistochemically using a Ki-67 antibody. Whole-body 18F-FDG-PET scans were performed on a GE advanced PET scanner 40 min after intravenous injection of 300–380 MBq 18F-FDG. Results: None of the patients with extranodal MZL showed focal tracer uptake within verified tumor sites. In contrast, 5 of the 6 patients with nodal MZL showed significant FDG uptake within the affected lymph nodes. These results did not simply reflect the different growth fractions of the two lymphoma entities since the proliferation indices of the two groups did not differ significantly. Conclusion:18F-FDG-PET visualizes nodal MZL in a high proportion of patients whereas FDG uptake is undetectable in extranodal MZL. Although limited by the small number of patients, this study suggests that imaging with 18F-FDG-PET might play a potential role in the diagnostic workup of patients with nodal MZL involvement.

Keywords:
18F-fluorodeoxyglucose, Mucosa-associated lymphoid tissue, Marginal zone lymphoma, Positron emission tomography
1.
Isaacson PG, Wright DH: Malignant lymphoma of mucosa associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983;52:1410–1416.
2.
Isaacson PG: Gastric MALT-lymphoma: From concept to cure. Ann Oncol 1999;10:637–645.
3.
Neubauer A, Thiede C, Morgner A, Alpen B, Ritter M, Neubauer B, Wundisch T, Ehninger G, Stolte M, Bayerdorffer E: Cure of Helicobacter pylori expression and duration of remission of low-grade gastric mucosa-associated lymphoid tissue lymphoma. J Natl Cancer Inst 1997;89:1350–1355.
4.
Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Cleary ML, Delsol G, De Wolf-Peeters C, Falini B, Gatter KC: A Revised European-American Classification of lymphoid neoplasms: A proposal from the International Lymphoma Study Group. Blood 1994;84:1361–1392.
5.
Raderer M, Isaacson PG: Extranodal lymphoma of MALT-type: Perspective at the beginning of the 21st century. Expert Rev Anticancer Ther 2001;1:53–64.
6.
Nathwani B, Anderson JR, Armitage JO, Cavalli F, Diebold J, Drachenberg MR, Harris NL, MacLennan KA, Muller-Hermelink HK, Ullrich FA, Weisenburger DD: Marginal zone B-cell lymphoma: A clinical comparison of nodal and mucosa-associated lymphoid tissue types. J Clin Oncol 1999;17:2486–2492.
7.
Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD: The World Health Organization Classification of Neoplastic Diseases of the Hematopoietic and Lymphoid Tissues. Ann Oncol 1999;10:1419–1432.
8.
Hoffmann M, Kletter K, Diemling M, Becherer A, Pfeffel F, Petkov V, Chott A, Raderer M: F18-FDG-PET does not visualize extranodal B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Ann Oncol 1999;10:1185–1189.
9.
Smith TAD, Titley JC, McReady VR: Proliferation is associated with 2-deoxy-D-[1-3H] glucose uptake by T47D breast tumour and SW480 and SW620 colonic tumour cells. Nucl Med Biol 1998;25:481–485.
10.
Minn H, Joensuu H, Ahonene A, Klemi P: Fluorodeoxyglucose imaging: A method to assess the proliferative activity of human cancer in vivo. Comparison with DNA flow cytometry in head and neck tumors. Cancer 1988;61:1776–1781.
11.
Higashi K, Ueda Y, Yagishita M, Arisaka Y, Sakurai A, Oguchi M, Seki H, Nambu Y, Tonami H, Yamamoto I: FDG PET measurement of the proliferative potential of non-small cell lung cancer. J Nucl Med 2000;41:85–92.
12.
Vesselle H, Schmidt RA, Pugsley JM, Li M, Kohlmyer SG, Vallires E, Wood DE: Lung cancer proliferation correlates with [F-18] fluorodeoxyglucose uptake by positron emission tomography. Clin Cancer Res 2000;6:3837–3844.
13.
Haberkorn U, Ziegler SI, Oberdorfer F, Trojan H, Haag D, Peschke P, Berger MR, Altmann A, van Kaick G: FDG uptake, tumor proliferation and expression of glycolysis-associated genes in animal tumor models. Nucl Med Biol 1994;21:827–834.
14.
Buck AC, Schirrmeister HH, Guhlmann CA, Diederichs CG, Shen C, Buchmann I, Kotzerke J, Birk D, Mattfeldt T, Reske SN: Ki-67 immunostaining in pancreatic cancer and chronic active pancreatitis: Does in vivo FDG uptake correlate with proliferative activity? J Nucl Med 2001;42:721–725.
15.
Brown RS, Leung JY, Kison PV, Zasadny KR, Flint A, Wahl RL: Glucose transporters and FDG uptake in untreated primary human non-small cell lung cancer. J Nucl Med 1999;40:556–565.
16.
Brown RS, Leung JY, Fisher SJ, Frey KA, Ethier SP, Wahl RL: Intratumoral distribution of tritiated-FDG in breast carcinoma: Correlation between Glut-1 expression and FDG uptake. J Nucl Med 1996;37:1042–1047.
17.
Higashi T, Tamaki N, Torizuka T, Nakamoto Y, Sakahara H, Kimura T, Honda T, Inokuma T, Katsushima S, Ohshio G, Imamura M, Konishi J: FDG uptake, GLUT-1 glucose transporter and cellularity in human pancreatic tumors. J Nucl Med 1998;39:1727–1735.
18.
Minn H, Clavo AC, Grenman R, Wahl RL: In vitro comparison of cell proliferation kinetics and uptake of tritiated fluorodeoxyglucose and L-methionine in squamous-cell carcinoma of the head and neck. J Nucl Med 1995;36:252–258.
19.
Herholz K, Rudolf J, Heiss WD: FDG transport and phosphorylation in human gliomas measured with dynamic PET. J Neurol Oncol 1992;12:159–165.
20.
Chott A, Raderer M: New developments in extracutaneous lymphomas. Semin Cutan Med Surg 2000;19:149–156.
© 2003 S. Karger AG, Basel
2003
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.