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Early-detection demo · Hematologic · DLBCL

Diffuse large B-cell lymphoma · Lugano III

Multi-station lymphadenopathy with FDG-avid mediastinal + axillary + inguinal nodes — biopsy confirmed DLBCL Lugano III.

Patient: Ingrid · 67 · B-symptomsModality: PET-CTRisk: high · 78/100
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01

Risk profile

What OCTON knew before the scan
Risk
78
high
Tier
high
6 weeks of drenching night sweats + 8% weight loss + non-tender right axillary + bilateral inguinal lymphadenopathy. CBC: WBC 9.4 (normal), LDH 412 (high).
Contributing factors
  • Persistent painless lymphadenopathy > 4 wk+22
  • B-symptoms (fever / sweats / weight loss)+24
  • LDH elevated 412+14
  • Age 67+8
  • Family history negative+0
  • No prior chemo / radiation+0
Narrative

Unexplained painless lymphadenopathy plus B-symptoms in an older adult is a textbook lymphoma red flag. PET-CT + excisional biopsy is the next step — DLBCL is curable with R-CHOP in ~60–70% of cases.

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Scan + AI report

What PET-CT found · FDG PET-CT whole-body (Lugano staging)
PET-CT · DEMO
Lugano III
OCTON · scanning · live
conf 0.85
OCTON Impression · 86% confidence

Multi-station FDG-avid lymphadenopathy: right paratracheal (SUVmax 14.2), bilateral axillary (SUVmax 12.6), bilateral inguinal (SUVmax 9.8). Spleen FDG-avid (SUVmax 7.2). No bone-marrow uptake. Deauville 5 / Lugano III.

Findings
  • Right paratracheal nodal mass · SUVmax 14.2 · Mediastinum
  • Bilateral axillary nodes · SUVmax 12.6 · Axillae
  • Bilateral inguinal nodes · SUVmax 9.8 · Inguinal
  • FDG-avid splenomegaly · Spleen
  • Deauville score 5 / Lugano III · Whole body
Differential diagnosis
  • Diffuse large B-cell lymphoma (DLBCL)55%
  • Hodgkin lymphoma (classical)20%
  • Follicular lymphoma (transformed)15%
  • Reactive lymphadenopathy (infectious)10%
Recommended actions
  • ▸Excisional cervical / axillary lymph-node biopsy (NOT FNA)
  • ▸Flow cytometry + IHC + FISH (MYC, BCL2, BCL6)
  • ▸Bone-marrow biopsy if biopsy-confirmed lymphoma
  • ▸Cardiac echo before R-CHOP (anthracycline)
  • ▸Hepatitis B/C + HIV screening before rituximab
Caveats
  • Excisional biopsy preferred over FNA — needs preserved architecture.
  • DLBCL is curable in 60–70% with R-CHOP; rare double-hit subtype is more aggressive.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
Interim PET-CT (Deauville)
FrequencyAfter 2 + 4 cycles
Startsage 18
Lugano 2014
Medical
End-of-treatment PET-CT
FrequencyOnce
Startsage 18
Lugano 2014
Lifestyle 360°
Diet · exercise · sleep · stress — the behaviours that move the needle
Exercise
CBC + LDH at baseline + every cycle
FrequencyPer chemo schedule
Startsage 18
NCCN B-cell Lymphomas v3.2025
04

What changed

The early-detection win

Unexplained B-symptoms + lymphadenopathy → PET-CT showed Deauville 5 / Lugano III DLBCL — early staging is the difference between cure and progression.

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