Usefulness of F-18 FDG PET/CT in the evaluation of neck swelling in polymorphic posttransplant lymphoproliferative disorder after renal transplantation

A 38-year-old man with a history of renal transplantation presented with a 3-month history of bilateral neck swelling. Ultrasonography of the neck showed multiple enlarged lymph nodes at the bilateral neck. Histologic examination of a specimen from an excisional biopsy at right level II cervical lymph node revealed polymorphic posttransplant lymphoproliferative disorder. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography scan was performed for further evaluation. The scan revealed marked enlargement and intense hypermetabolism of the lymph nodes along the bilateral cervical lymph node chains (Fig. 1). Several reports have described that diverse infectious or inflammatory disorders and malignant diseases show various degree of FDG uptake of cervical lymph nodes. This case illustrates that the possibility of posttransplant lymphoproliferative disorder should be considered in renal transplant patients with increased FDG uptake of cervical lymph nodes on F-18 FDG positron emission tomography/computed tomography scan.