Homeopathic mistletoe adverse reaction mimics nodal involvement in 18F-FDG PET/CT performed for evaluation of response to chemotherapy in lymphoma

Rev Esp Med Nucl Imagen Mol. 2017 Mar-Apr;36(2):110-112. doi: 10.1016/j.remn.2016.07.005. Epub 2016 Sep 13.
[Article in English, Spanish]

Abstract

Some patients use complementary medicine. We present a patient with Hodgkin's lymphoma, scanned with 18F-FDG PET/CT for evaluation of response after chemotherapy, who was self-administering mistletoe as a homeopathic medicine product. The careful review of the images of the entire scan and patient collaboration in anamnesis were crucial to avoid a false positive result. A review of the published scientific data on the effects of mistletoe is also presented.

Keywords: (18)F-FDG; Evaluación de respuesta; Evaluation of response; Homeopathy; Homeopatía; Linfoma; Lymphoma; PET/CT; PET/TC.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Agents, Phytogenic / adverse effects*
  • Antineoplastic Agents, Phytogenic / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bleomycin / administration & dosage
  • Dacarbazine / administration & dosage
  • Doxorubicin / administration & dosage
  • Female
  • Fluorine Radioisotopes / analysis*
  • Fluorodeoxyglucose F18 / analysis*
  • Hodgkin Disease / diagnostic imaging*
  • Hodgkin Disease / drug therapy
  • Humans
  • Injections, Subcutaneous
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / drug effects
  • Materia Medica / adverse effects*
  • Neoplasm Staging
  • Phytotherapy / adverse effects*
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals / analysis*
  • Ribosome Inactivating Proteins, Type 2 / administration & dosage
  • Ribosome Inactivating Proteins, Type 2 / adverse effects*
  • Ribosome Inactivating Proteins, Type 2 / therapeutic use
  • Self Medication
  • Subcutaneous Fat / diagnostic imaging
  • Subcutaneous Fat / metabolism
  • Toxins, Biological / administration & dosage
  • Toxins, Biological / adverse effects*
  • Toxins, Biological / therapeutic use
  • Vinblastine / administration & dosage
  • Viscum album / adverse effects*

Substances

  • Antineoplastic Agents, Phytogenic
  • Fluorine Radioisotopes
  • Materia Medica
  • Radiopharmaceuticals
  • Ribosome Inactivating Proteins, Type 2
  • Toxins, Biological
  • mistletoe lectin I
  • Fluorodeoxyglucose F18
  • Bleomycin
  • Vinblastine
  • Dacarbazine
  • Doxorubicin
  • Fluorine-18

Supplementary concepts

  • ABVD protocol