18F-FDG PET/CT imaging findings in anaplastic large cell lymphoma, a rare subtype of lymphoma

Objective To investigate the F-18-FDG PET/CT imaging manifestations for anaplastic large cell lymphoma (ALCL), a rare subtype of T/NK cell lymphoma. Methods Fifty patients with ALCL, including 32 anaplastic lymphoma kinase (ALK)-positive patients and 18 ALK-negative patients, were enrolled. The positive detection, maximal standardized uptake value (SUVmax), and distribution of nodal and extranodal involvement were recorded and analysed. Fifty patients with diffuse large B cell lymphoma (DLBCL) were collected as a control group. Results ALCL lesions were demonstrated to be F-18-FDG-avid tumours with a mean SUVmax of 19.4 +/- 12.6. Most (76%) ALCL patients presented with stage III-IV disease, and nodal and extranodal involvement occurred in 74.0 and 72.0% of the patients, respectively. ALCL and DLBCL showed many similarities in tumour stage, F-18-FDG uptake and tumour involvement (P > 0.05), although the preferred extranodal organs of involvement (bone and the gastrointestinal tract, respectively) were different (P < 0.05). Compared to ALK-negative lesions, a higher uptake of F-18-FDG was found in the ALK-positive lesions (SUVmax: 22.1 +/- 14.3 vs. 15.1 +/- 6.6, t = 2.354, P = 0.023). ALK-positive ALCL was more likely to involve the lymph nodes than ALK-negative ALCL (84.3% vs. 55.5%, chi(2) = 4.973, P = 0.043), while ALK-negative ALCL was more prone to involve the extranodal organs compared to ALK-positive ALCL (88.9% vs. 62.5%, chi(2) = 3.979, P = 0.046). Conclusion The present study demonstrated that ALCL is a systemic F-18-FDG-avid lymphoma with many imaging manifestations similar to DLBCL on PET/CT. The present study also showed that ALK expression actually influenced tumour F-18-FDG uptake and lesion distribution. These findings may be useful to improve the understanding of the biological characteristics of ALCL.