Abstract
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Objectives FDG is not a tumor-specific tracer and can accumulate in the sites of different infections and inflammation. The objective of the current study was to review of the FDG PET/CT imaging features of lymphoma involved in the lymph node and analyze the lymphadenopathy mimicking lymphoma on FDG PET/CT.
Methods The PET/CT imaging characteristics, including lesion size, distribution, standardized uptake value (SUV), of 72 lymphoma patients (age range: 6-82 years) diagnosed by PET/CT were retrospectively analyzed. Final diagnosis was made by pathology (65 cases) or clinical follow-up (7 cases). Diagnostic efficiency of FDG PET/CT was calculated and the misdiagnosis was evaluated.
Results /b> (1) 72 patients had lymph node involvement: lymphadenopathy of bilateral diaphragm in 29/72 (40.3%), multiple lymphadenopathy of unilateral diaphragm in 32/72 (44.4%), single regional lymphadenopathy in 11/72 (15.3%). (2) Extranodal lesions with intense FDG uptake were found in 42/72 (58.3%) with 24 spleen involvement, 8 bone involvement, 4 lung involvement, 2 testicles involvement, 1 tonsil and 1 nasopharynx involvement, 1 thymus and 1 brain involvement. (3) The PET/CT diagnosis was consistent with the final diagnosis in 56/72 (77.8%). The 16 cases of misdiagnosis included tuberculous lymphadenitis (7/16), non-specific inflammation (2/16), sarcoidosis (2/16), pulmonary cancer of mediastinal type (2/16), secondary melanoma (1/16), lymphadenopathy with chronic lymphocytic leukemia (1/16), and lymphadenopathy with AIDS (1/16). (4) The FDG PET/CT features of 7 cases with tuberculous lymphadenitis: the size of the lesions ranged from 0.9 to 3.3 cm; the distribution of the lesions consisted of lymphadenopathy with bilateral diaphragm (3/7), multiple lymphadenopathy with unilateral diaphragm (2/7), and single regional lymphadenopathy (2/7); extranodal lesions were found in 4/7 with 2 spleen involvement, 1 bone involvement and 1 lung involvement; FDG uptake was definitely increased in 7 cases with the maximum SUV of 5.3-16.7.
Conclusions Conclusions: Differentiation between lymphoma and some lymphadenopathy can be difficult on FDG PET/CT, especially with the tuberculous lymphadenitis. A tumor-specific tracer may be a better choice to solve the problem. Key words: FDG PET/CT; lymphoma; misdiagnosis; lymphadenopathy; tuberculous lymphadeniti s
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