Blood and Lymphatic Cancer: Targets and Therapy (Mar 2022)
Neuropsychiatric Manifestations of Lymphoma-Associated Cerebral Glucose Hypometabolism Can Be Reversed by Intensive Glucose Supplementation
Abstract
Adam M Kase,1 Catherine Bullock,2 Ricardo Parrondo,1 Muhamad Alhaj Moustafa,1 Madiha Iqbal,1 K David Li,3 Ephraim E Parent,4 Han Tun1 1Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA; 2Department of Internal Medicine, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA; 3Department of Pathology, Mayo Clinic Hospital, Jacksonville, FL, 32224, USA; 4Nuclear Medicine Division of Radiology Department, Mayo Clinic, Jacksonville, FL, 32224, USACorrespondence: Adam M Kase, Division of Hematology and Medical Oncology, Mayo Clinic, 4500 San Pablo Road South, Jacksonville, FL, USA, Tel +1 904-953-2000, Fax +1 904-953-2315, Email [email protected]: Cerebral glucose hypometabolism (CGHM) is characterized by diffuse or focal reduction in uptake of glucose by the brain as determined on a FDG PET-CT. We report a case of lymphoma-associated cerebral glucose hypometabolism (LA-CGHM) in a patient with hepatosplenic T-cell lymphoma (HSTCL) whose neuropsychiatric symptoms were resolved with glucose supplementation. PET-CT scan showed diffuse cerebral hypometabolism in addition to focal hypermetabolism in the liver related to lymphomatous involvement. He responded rapidly to infusion of 10% dextrose with complete resolution of neurological symptoms on two separate occasions and was later maintained on oral glucose without relapse. While his neuropsychiatric symptoms improved, his aggressive lymphoma and chemo-refractory disease ultimately led to his demise. We suggest that LA-CGHM can cause neuropsychiatric manifestations which can be reversed by intensive glucose supplementation.Keywords: cerebral hypometabolism, hepatosplenic T-cell lymphoma, non-Hodgkin’s lymphoma, glucose hypometabolism FDG PET-CT
