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FIGURE 1. 27-year-old woman with HD (nodular sclerosis) who underwent PET/CT for initial staging. (A) Axial low-dose unenhanced CT showed no pathologic findings in upper abdomen. Small finding in splenic hilum (arrow) was considered to be vessel or accessory spleen. (B) Axial full-dose contrast-enhanced CT at same level demonstrated small lymphadenopathy at splenic hilum that, because of its small diameter (arrows), was not considered pathologic. No other abnormalities were seen in abdomen or pelvis. (C) Axial PET at same level showed, next to splenic hilum, a small, focal area of increased 18F-FDG uptake whose anatomic origin and location were difficult to determine (arrows). (D) Axial full-dose enhanced PET/CT clearly demonstrated that pathologic uptake corresponded to small adenopathy in splenic hilum (arrows). Mediastinal and cervical disease were also assessed (not shown). Because no other abdominal or pelvic disease was found, full-dose PET/CT led to upstaging from stage II to stage III.
