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PET/CT examination in an anaplastic malignant lymphoma with extensive reactive involvement.

A woman with leukocytosis, increased C-reactive protein (CRP), and clinical pneumonia exhibited overactivation of the immunologic system with elevated interleukin (IL)-6 and IL-17 levels. A PET/CT FDG imaging demonstrated an unusual finding with extensive lymphadenopathy with intense tracer uptake and increased uptake by the bone marrow and spleen. Biopsy showed an anaplastic large cell lymphoma. This may especially produce IL-6, which is a potent pyrogen and an inducer of CRP. It is also associated with systemic inflammatory features and probably mediated the inflammatory presentation. The bulk of the extensive tumor consisted of reactive lymphatic cells probably giving rise to most of the tracer accumulation with the spectacular findings on F-18 FDG PET/CT imaging.