Lymphoma Case 03


Clinical History
73-year-old female was referred for a PET/CT scan for primary staging of Hodgkin's lymphoma.

Imaging Findings
NUCLEAR MEDICINE PET/CT
STATED REASON FOR REQUEST: Staging Hodgkin's lymphoma
TECHNIQUE: Emission scanning from the neck through the pelvis was obtained approximately 88 minutes post injection, with a standard scan time of 2 minutes per PET bed position.

PET/CT FINDINGS: The PET/CT study showed a matted hypermetabolic lymph node mass in the left axilla. A solitary hypermetabolic para-aortic nodal lesion was visualized (red arrow) below the lymph node mass which suggested more advanced disease. There was a small focal hypermetabolic lesion in the right axilla adjacent to the brachial artery that suggested a lymphomatous lesion in the opposite axilla as well.

A small focal area of increased uptake in the right chest wall was visualized (white arrow) corresponding to a small area of increased density on CT. This lesion was deemed to be a lymphomatous deposit but a co-existing early primary breast tumor could not be ruled out. A biopsy of the subcutaneous lesion was advised for further evaluation.

Discussion
The clear delineation of the lymph node mass in the left axilla and small lesions in the right axilla, para-aortic and the right chest wall helped the physician correctly stage the patient and aided in the selection of the most appropriate treatment.

Data courtesy of University of Tennessee Medical Center, Knoxville, TN, USA

* Any of the protocols presented herein are for informational purposes and are not meant to substitute for clinician judgment in how best to use any medical devices. It is the clinician that makes all diagnostic determinations based upon education, learning and experience.