PMC7154270_01
CT scan of the abdomen performed after the first episode of relapse in April 2014 (left) versus follow-up CT scan performed in October 2018, 1 month after the completion of 8 cycles of brentuximab vedotin with 3 cycles of gemcitabine (right). Axial (A, B) and coronal (C, D) views showing an enlarged right psoas major muscle (red arrow). The previously enlarged right psoas major muscle (diameter of 7.2 cm) has returned to normal size (diameter of 3 cm). The previously enlarged left inguinal lymph nodes with a mean diameter of 1.4 cm (E, red and blue arrows) were no longer observed on follow-up CT scan (F).
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F1
Ultrasound and CT scan examination showed multiple cervical, axillary, and inguinal lymphadenopathies, with hypertrophy of her right psoas major muscle, suggesting the presence of muscle infiltration (Fig 1). The patient showed significant clinical improvements after 5 cycles of BV (Fig 1).
Cervical CT scan performed before the initiation of brentuximab vedotin (BV) in August 2017 (top), sagittal (A), axial (B), and coronal (C) views showing an enlarged right cervical lymph node (red arrow) on the level of C1-C4 with a diameter of 6.5 cm. D Follow-up PET scan performed after 5 cycles of BV and 1 cycle of BV + gemcitabine in June 2018, showing small residual lesions with mild metabolic activity and a necrotic area, suggesting partial response (PR).
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F2
One year after her 3rd line therapy (in August 2017), the patient complained of recurrent headache with progressive neck swelling (Fig 2). fine-needle aspiration biopsy was performed on her right retro-auricular lymph node (August 2017), showing cancerous cells consistent with HL.
Whole body CT scan performed 1 month after treatment completion showing no sign of residual lesion.
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F3
PET scan was performed 1 month after the 6th cycle of BV (Fig 3).