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Figure
1 |
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Figure
2 |
History:
23 year old male with a large mediastinal mass seen on outside chest
x-ray (Figure 1) and CT (Figure 2). Biopsy indicated Hodgkins
Lymphoma. Patient was referred to Main Street Radiology for
whole body PET scan.
Findings:
Coronal whole body image (Figure 3) demonstrates multiple
hypermetabolic areas (dark) in the mediastimum and neck (small
arrows), compatible with lymphadenopathy. Normal physiological
activity within the urinary bladder is seen.
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Figure
3 |
On the axial image of the chest (Figure
4), extensive mediastinal lymphadenopathy is seen corresponding to the
CT finding. A photopenic (light) area is seen in the mediastinum
(arrow on Figure 4) corresponding to necrosis seen on CT (arrow on
Figure 2). Abnormal right internal mammary lymph node is also seen on
PET (Figure 5), which was not appreciated on CT.
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Figure
4 |
Figure
5 |
Discussion:
Numerous clinical studies have shown that PET is the best imaging
modality for lymphoma, superior to CT, MR, and gallium scan. In the
management of lymphoma, PET is indicated for initial staging as well
as to monitor response to treatment and to exclude recurrence. PET is
especially useful in distinguishing tumor from necrosis and fibrosis.
Clinical Case
Studies
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Main
Street Radiology
PET
Clinical
Case Studies |
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