FDG PET/CT findings and post-treatment changes of COVID-19 pneumonia in a patient with lymphoma: A case report.

A 29-year-old male with a history of Hodgkin's lymphoma presented for evaluation of response to chemotherapy with positron emission tomography/computed tomography using fluorine-18-fluoro-2-deoxy-d-glucose (18F-FDG PET/CT). Follow-up 18F-FDG PET/CT imaging demonstrated resolution of previously noted FDG avid axillary lymphadenopathy. However, multiple opacities with increased FDG uptake were noted in the lungs bilaterally, which were suspicious for pulmonary infection, including viral pneumonia. The patient tested positive for coronavirus disease 2019 (COVID-19) virus infection by reverse transcription-polymerase chain reaction (RT-PCR). Additional cycles of chemotherapy were delayed until the patient became negative for COVID-19 virus infection on follow-up RT-PCR test 2 weeks later. The patient received two additional cycles of chemotherapy. Follow-up 18F-FDG PET/CT post chemotherapy demonstrated a decrease in the size of the previously seen mediastinal lymphadenopathy, reduction of FDG uptake by the previously seen mediastinal lymphadenopathy, and reduction of FDG uptake by the previously seen pulmonary opacities, at 2 months after COVID-19 diagnosis. The findings of this case report demonstrated the importance of recognition of pulmonary abnormalities caused by COVID-19 pneumonia on 18F-FDG PET/CT imaging for clinical management of patients with lymphoma.