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A case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "272" "paginaFinal" => "273" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Sandoval-Moreno, J.A. Duarte-Luna, C. Escolano-Escobar, B. Manzarbeitia-Arroba, A. Herrero-Muñoz, M.Á. Balsa-Bretón" "autores" => array:6 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Sandoval-Moreno" "email" => array:2 [ 0 => "cristycsm@gmail.com" 1 => "cristina.sandoval@salud.madrid.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J.A." "apellidos" => "Duarte-Luna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Escolano-Escobar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "B." "apellidos" => "Manzarbeitia-Arroba" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Herrero-Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "M.Á." "apellidos" => "Balsa-Bretón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Hospital Universitario de Getafe, Getafe, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario de Getafe, Getafe, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Hematología, Hospital Universitario de Getafe, Getafe, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reacción granulomatosa inducida por nivolumab. A propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1328 "Ancho" => 2351 "Tamanyo" => 202258 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "18F-FDG-PET/CT studies after initiation of immunotherapy with Nivolumab. (a) Baseline study, with evidence of pathological FDG uptake in mediastinal lymphadenopathy, hilar and bone involvement. (b) Control two months after the start of treatment: response of the bone involvement with persistent adenopathic involvement. (c) Control five months after the start of treatment: adenopathic progression with supra and infradiaphragmatic involvement." ] ] ] "textoCompleto" => "The development of immunotherapy-based treatments has led to a change in the management of different neoplasms, as well as in the interpretation of imaging tests during follow-up.We present the case of a patient diagnosed with stage IIIA Hodgkin’s Lymphoma (HL) who, after autotransplantation, has an early relapse with mediastinal adenopathic and bone involvement, with a positive biopsy for PD-1 and PDL-1. Treatment with Nivolumab prior to allogeneic transplantation was administrated.PET/CT studies (Siemens Biograph 6) were performed (including orbits to proximal thighs), after intravenous administration of 3.7 MBq/kg of 18F-FDG and fasting for 6 h, for follow up. Two months after the start of immunotherapy, response to treatment was evidenced on the bone metastasis with persistence of lymph node involvement. Three months later the PET/CT showed lymph node progression (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Given the clinical-radiological disassociation, a lymph node biopsy was performed with the result of non-necrotizing granulomatous lymphadenitis in both cases (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>Immunotherapy is based on activating the immune system through various mechanisms, unblocking the inhibitory pathways (CTLA-4 or PD-1/PDL-1) and stimulating T lymphocytes<a class="elsevierStyleCrossRef" href="#bib0005">1</a>. Nivolumab is a monoclonal IgG4 antibody against the PD-1 receptor being indicated in the treatment of LH<a class="elsevierStyleCrossRef" href="#bib0005">1</a>.Pseudoprogression consists of an increase in size, metabolism and number of lesions due to an infiltration of inflammatory cells, necrosis and T lymphocytes. It is described in up to 10% of the treatments with anti-PD-1, sarcoidosis being one of the effects less frequent adverse events<a class="elsevierStyleCrossRef" href="#bib0005">1</a>.It has been reported that in active sarcoidosis, the PD-1 receptor is increased with overexpression of PDL-1<a class="elsevierStyleCrossRef" href="#bib0010">2</a>. On the other hand, it has been observed that T cells with PD-1 expression regain their proliferative capacity with anti-PD-1<a class="elsevierStyleCrossRef" href="#bib0010">2</a>. Although these theories could explain the development of inflammatory pathologies, it has not been established as a cause.Several criteria to assess the response to immunotherapy treatments have been published (irREiCIST, PECRIT, PERCIMT …), without establishing any of them. What they seem to agree on is that the progression of the disease must be confirmed in separate studies at least four weeks before deciding to suspend treatment in those patients with clinical improvement<a class="elsevierStyleCrossRef" href="#bib0015">3</a>. For this reason, together with the negative biopsy for malignancy obtained two months after starting Nivolumab, it was decided to continue treatment given the clinical benefit that could be obtained.This case shows us the importance of knowing the possible side effects of immunotherapy and its diagnosis, differentiating them from a true progression of the disease in order to offer patients the best therapeutic option." "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1328 "Ancho" => 2351 "Tamanyo" => 202258 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "18F-FDG-PET/CT studies after initiation of immunotherapy with Nivolumab. (a) Baseline study, with evidence of pathological FDG uptake in mediastinal lymphadenopathy, hilar and bone involvement. (b) Control two months after the start of treatment: response of the bone involvement with persistent adenopathic involvement. (c) Control five months after the start of treatment: adenopathic progression with supra and infradiaphragmatic involvement." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1274 "Ancho" => 2176 "Tamanyo" => 457323 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Biopsy for Aortopulmonary window adenopathy biopsy. A and B. Nodal tissue replaced by numerous aggregates of epithelioid histiocytes forming microgranulomas, without necrosis." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immunotherapy, cancer and PET" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Simó-Perdigó" 1 => "J.L. Vercher-Conejero" 2 => "S. Viteri" 3 => "M.J. García-Velloso" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2021.02.001" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol" "fecha" => "2021" "volumen" => "40" "paginaInicial" => "123" "paginaFinal" => "135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33674234" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nivolumabinduced sarcoid-like granulomatous reaction in a patient with advanced melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.X. Danlos" 1 => "C. Pages" 2 => "B. Baroudjian" 3 => "L. Vercellino" 4 => "M. Battistella" 5 => "M. Mimoun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.chest.2015.10.082" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2016" "volumen" => "149" "paginaInicial" => "e133" "paginaFinal" => "e136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27157227" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Criteria of metabolic response to immunotherapy [Article in English, Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Mucientes Rasilla" 1 => "L. Gutiérrez Sanz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2019.10.002" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol (Engl Ed)" "fecha" => "2020" "volumen" => "39" "paginaInicial" => "51" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31806574" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22538089/0000004200000004/v1_202307170957/S2253808922000738/v1_202307170957/en/main.assets" "Apartado" => array:4 [ "identificador" => "7927" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Interesting images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22538089/0000004200000004/v1_202307170957/S2253808922000738/v1_202307170957/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2253808922000738?idApp=UINPBA00004N"]

ISSN: 2253-8089

The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles. The works may be submitted in Spanish or English and are subjected to a peer review process. In 2009, it became the leading Spanish journal in the field of Medical Imaging on having an Impact Factor , awarded by the Journal Citation Reports.

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Impact factor

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Impact factor 2023

1.6

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1.1

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SJR 2023

0.208

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SNIP 2023

0.273

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