Clin Nucl Med 1999 May;24(5):319-22
Fluorine-18 fluorodeoxyglucose splenic uptake from extramedullary
hematopoiesis after granulocyte colony-stimulating factor stimulation.
Abdel-Dayem HM, Rosen G, El-Zeftawy H, Naddaf S, Kumar M, Atay S, Cacavio A.
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.
