Waldenström's macroglobulinemia CT

Waldenström's macroglobulinemia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2] Mirdula Sharma, MBBS [3] Roukoz A. Karam, M.D.[4]

Overview

In Waldenstrom's macroglobulinemia, CT scan imaging of chest, abdomen, and pelvis may show evidences of lymphadenopathy and hepatomegaly. CT of the lungs or abdomen can also be diagnostic for infection, which is particularly relevant to immunocompromised patients.

CT scan

• CT scan imaging with IV contrast of chest, abdomen, and pelvis can be done to measure the tumor load.
• Waldenstrom's macroglobulinemia shows evidence of lymphadenopathy, and hepatosplenomegaly.
• CT of the lungs or abdomen can also be diagnostic for infection, which is particularly relevant to immunocompromised patients.

Abdominal computed tomography (CT) showing significant hemoperitoneum, with extravasation of contrast into the right flank/para-colic gutter. Hepatomegaly and splenomegaly are clearly seen.Source: Charakidis M. et al, Department of Haematology-Oncology, Royal Hobart Hospital, Tasmania, 7000, Australia.

Transaxial slices representative of isodose distribution of 3D-CRT treatment plan delivered for the whole spleen. A, In the first stage, isodose curves were produced by 3 oblique isocentric photon fields of beam quality 10-MV; B, In the second stage, isodose curves were produced by 5 oblique isocentric photon fields of beam quality 10-MV.Source: Wei Z. et al, Department of Radiotherapy, Cancer Centre, Qilu Hospital, Shandong University, 107 Wenhuaxi Street, Jinan, Shandong 250012, China.

Response to mTOR-inhibitor treatment in Waldenstrom's macroglobulinemia and lung toxicity.Baseline contrast-enhanced coronal CT images in 59-year-old woman show retroperitoneal lymphadenopathy (black arrows) and mild splenomegaly (A). Five months after start of treatment, coronal contrast-enhanced CT shows decreased adenopathy and splenomegaly (B). At baseline, clear lung bases were present (C). On five month follow-up CT (D), new ground-glass and reticular opacities developed in lung bases (white arrows), in keeping with mTOR-associated pneumonitis. Patient was asymptomatic. mTOR = mammalian target of rapamycin.Source: Krajewski KM. et al, Department of Imaging, Dana-Farber Cancer Institute, Boston, MA 02215, USA.; Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA

(A) Contrast enhanced axial and coronal T1-weighted images show a well-enhanced mass along the left tentorium and cavernous sinus (arrows). This mass also extends into the contralateral tentorium and falx (arrowheads). (B) Marked decrease in the size of the mass in the tentorium and falx after radiation therapy and fludarabine treatment.Source: Kim HD. et al, Department of Internal Medicine, Yeoungnam University College of Medicine, Daegu, Korea.

Sequential computed tomography scan images at the same level. A, At the diagnosis of the disease (19/06/2008); B, Relapsed after chlorambucil and thalidomide (25/06/2009); C, Before the first stage of 3D-CRT (12/12/2009); D, Before the second stage of 3D-CRT (22/06/2010); E, At one month after the second stage of 3D-CRT (17/08/2010); F, At one year after the second stage of 3D-CRT (06/07/2011). Source: Wei Z. et al, Department of Radiotherapy, Cancer Centre, Qilu Hospital, Shandong University, 107 Wenhuaxi Street, Jinan, Shandong 250012, China.