Transformation of myelodysplastic syndrome to acute myeloid leukemia: a case with whole-body 2- (18F) fluoro-2-deoxy-D-glucose positron emission tomography

The case reported here was that of an old woman characterized by pancytopenia, chromosome clonal abnormality, fluctuation of the percent of blast cells at 20%, and negative evidence of malignancy in whole-body 2-(18F) fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET). After about 10 months, the blast cells accounted for about 25%, the morphology of which was similar to that of previous ones, and 18F-FDG PET demonstrated diffusing increased uptake in the right upper leg and lymph nodes and patchy high uptake of bone marrow. 2-(18F)-fluoro-2-deoxyglucose can reflect extramedullary infiltration and bone marrow cellularity of the whole body, compared with invasive, regional biopsies and aspirations. The value of 2-(18F)-fluoro-2-deoxyglucose or 3'-deoxy-3'-(18F)-fluorothymidine positron emission tomography as an indicator in predicting the transformation of myelodysplastic syndrome to acute myeloid leukemia needs to be explored in the future. (author)