{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:04:03Z","timestamp":1777878243380,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Hematology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>\n                    Combined\n                    <jats:sup>18<\/jats:sup>\n                    F-fluoro-deoxyglucose ([18F]FDG) positron emission tomography and computed tomography ([18F]FDG-PET\/CT) is increasingly used for the diagnostic and therapeutic management of hematologic and non-hematologic malignancies. Here, we describe a unique case of a patient presenting with very severe aplastic anemia and a mediastinal mass showing disseminated hypermetabolic lesions of the bones after receiving granulocyte colony-stimulating factor (G-CSF), highly suspicious for disseminated metastatic lesions. A 71-year-old patient presented with a 3\u2009week history of dyspnea and fatigue. Blood tests showed severe pancytopenia and iliac crest bone marrow biopsy revealed an extensively hypoplastic bone marrow. Diagnostic work-up by histology, conventional cytogenetics and flow cytometry confirmed the diagnosis of very severe aplastic anemia. Besides blood transfusions, the patient was treated with G-CSF. Furthermore, computed tomography revealed a suspect mass in the anterior mediastinum, presenting with moderate glucose metabolism in the subsequent [18F]FDG-PET\/CT scan. In addition, multiple disseminated and highly metabolic bone lesions of primarily the ribs were detected, suspicious of malignant bone infiltration. Since physiologic bone marrow activation by G-CSF-stimulation could not be ruled out, G-CSF therapy was interrupted to repeat the PET\/CT scan 10\u2009days later. On the second [18F]FDG-PET\/CT the moderately hypermetabolic mediastinal mass persisted. However, the initially FDG-avid bone lesions almost completely resolved, rendering the diagnosis of G-CSF-induced bone marrow hypermetabolism very likely without the need for further invasive diagnostic procedures. The mediastinal mass was thereafter histologically verified as thymoma. Interpretation of [18F]FDG-PET\/CT in patients with aplastic anemia may be complicated by the frequent therapeutic use of G-CSF. With G-CSF, islets of residual bone marrow activity can be visualized on [18F]FDG-PET\/CT images that might be misinterpreted as malignant bone infiltration. Repeating PET\/CT scan after G-CSF discontinuation can prevent unnecessary invasive diagnostic procedures in these patients.\n                  <\/jats:p>","DOI":"10.1177\/2040620720977613","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T02:02:57Z","timestamp":1608602577000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Disseminated focal\n                    <sup>18<\/sup>\n                    F-fluoro-deoxyglucose uptake upon granulocyte colony-stimulating factor therapy mimicking malignant bone infiltration: case report of a patient with very severe aplastic anemia"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1509-4324","authenticated-orcid":false,"given":"Lena","family":"Horvath","sequence":"first","affiliation":[{"name":"Department of Internal Medicine V (Hematology and Oncology), Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Seeber","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V (Hematology and Oncology), Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Uprimny","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Tyrol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V (Hematology and Oncology), Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Nachbaur","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V (Hematology and Oncology), Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Tirol, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Kocher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine V (Hematology and Oncology), Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Tirol 6020, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,12,21]]},"reference":[{"key":"bibr1-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.1.173"},{"key":"bibr2-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13853"},{"key":"bibr3-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-010-1531-0"},{"key":"bibr4-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1016\/j.nucmedbio.2006.09.005"},{"key":"bibr5-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1007\/s12149-009-0286-9"},{"key":"bibr6-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2016.07.001"},{"key":"bibr7-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-016-4568-z"},{"key":"bibr8-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1097\/01.rlu.0000242685.55001.67"},{"key":"bibr9-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-200410000-00010"},{"key":"bibr10-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1097\/01.rlu.0000079394.76990.08"},{"key":"bibr11-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1007\/s12149-008-0146-z"},{"key":"bibr12-2040620720977613","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-13-00183.1"},{"key":"bibr13-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0000000000000491"},{"key":"bibr14-2040620720977613","doi-asserted-by":"publisher","DOI":"10.7150\/jca.24836"},{"key":"bibr15-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1097\/00003072-199802000-00007"},{"key":"bibr16-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.2305"},{"key":"bibr17-2040620720977613","first-page":"3215","volume":"16","author":"Chen M","year":"2018","journal-title":"Oncol Lett"},{"key":"bibr18-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e3181becead"},{"key":"bibr19-2040620720977613","first-page":"84","volume":"52","author":"Hirata H","year":"2011","journal-title":"Rinsho Ketsueki"},{"key":"bibr20-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1626489"},{"key":"bibr21-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.1990.tb00420.x"},{"key":"bibr22-2040620720977613","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05574.x"},{"key":"bibr23-2040620720977613","doi-asserted-by":"publisher","DOI":"10.2217\/cpr.14.55"},{"key":"bibr24-2040620720977613","volume":"105","author":"Gendron N","year":"2019","journal-title":"Haematologica"}],"container-title":["Therapeutic Advances in 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