Oncological PETCT with Histological Confirmation by Juliano Cerci Stefano Fanti & Dominique Delbeke

Author:Juliano Cerci, Stefano Fanti & Dominique Delbeke
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Case 4.4

A 31-year-old male with newly diagnosed diffuse large B-cell lymphoma.

Fig. 4.4(a) 18F-FDG MIP; (b) fused 18F-FDG PET/CT and low-dose CT transaxial images of the mediastinum; (c) fused 18F-FDG PET/CECT and CECT transaxial images of the mediastinum (d) fused PET/CECT and CECT transaxial images of the upper abdomen

18 F-FDG PET/CT findings: (a, b, c) Mediastinal bulky mass with heterogeneous 18F-FDG uptake, mainly peripheral, as well as small hypermetabolic lymph nodes in the right subclavian and left para-aortic regions. (d) Extranodal intense 18F-FDG-avid lesions in both adrenals, head of the pancreas, the greater gastric curvature, and the right kidney. Conclusion: stage IV partly necrotic mediastinal bulky mass with extranodal involvement (adrenals, head of the pancreas, right kidney, stomach).

Biopsy: Diffuse large B-cell lymphoma

Recommendations: Staging aggressive NHL. 18F-FDG PET/CT scan can guide biopsy to site of high 18F-FDG uptake in a bulky mass. At staging 18F-FDG PET/CT contributes to prognostication in terms of Ann Arbor status and extranodal involvement (IPI score).

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