Fluorine-18 fluorodeoxyglucose splenic uptake from extramedullary hematopoiesis after granulocyte colony-stimulating factor stimulation

Clin Nucl Med. 1999 May;24(5):319-22. doi: 10.1097/00003072-199905000-00004.


Two patients with sarcoma, one with recurrent osteosarcoma of the spine and the other with metastatic synovial cell sarcoma, were treated with high-dose chemotherapy that produced severe leukopenia. The patients received granulocyte colony-stimulating factor (G-CSF) to stimulate the bone marrow (480 mg given subcutaneously twice daily for 5 to 7 days); their responses were seen as a marked increase in peripheral leukocyte count with no change in the erythrocyte or platelet counts. The patients had fluorine-18 fluorodeoxyglucose (F-18 FDG) imaging 24 hours after the end of G-CSF treatment. Diffusely increased uptake of F-18 FDG was seen in the bone marrow in both patients. In addition, markedly increased uptake in the spleen was noted in both, indicating that the spleen was the site of extramedullary hematopoiesis. The patients had no evidence of splenic metastases. The first patient had a history of irradiation to the dorsal spine, which was less responsive to G-CSF administration than was the nonirradiated lumbar spine.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects
  • Bone Marrow / diagnostic imaging
  • Female
  • Fluorodeoxyglucose F18*
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hematopoiesis, Extramedullary*
  • Humans
  • Leukopenia / chemically induced
  • Leukopenia / therapy
  • Middle Aged
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Spleen / diagnostic imaging*
  • Spleen / physiology


  • Antineoplastic Agents
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Granulocyte Colony-Stimulating Factor