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Reactive Tonsillar Enlargement Showing Strong 18F-Fdg Uptake During the Follow-Up of Follicular Lymphoma |
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| Authors: | Patricia do Socorro Queiroz Feio Camilla Borges Ferreira Gomes Alexandre Simões Nogueira Luciana Yamamoto Almeida José Vassallo Fernando Augusto Soares Oslei Paes Almeida Jorge Esquiche León |
| Affiliation: | 1. Department of Oral Diagnosis, Oral Pathology, Dentistry School, University of Campinas (UNICAMP), Av. Limeira, 901 Caixa Postal 52, Piracicaba, SP, 13414-903, Brazil 2. School of Dentistry, Federal University of Ceará, Sobral Campus, Rua Stanislau Frota s/n - antiga fábrica de tecidos Centro, Sobral, CE, 62010-560, Brazil 3. Laboratory of Investigative and Molecular Pathology – CIPED, State University of Campinas Medical School (FCM/UNICAMP), Rua Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, Campinas, SP, 13083-887, Brazil 4. Department of Pathology, Cancer Educational and Research Center Hospital AC Camargo, Rua Prof. Ant?nio Prudente, 109 - 1o andar Anatomia Patológica, Liberdade, S?o Paulo, SP, 01509-010, Brazil 5. Department of Morphology, Stomatology and Physiology, Oral Pathology, Dentistry School, University of S?o Paulo (USP), Av. do Café s/n Monte Alegre, Ribeir?o Preto, SP, 14040-904, Brazil |
| Abstract: | The 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has become a standard procedure for the diagnosis, staging, and restaging in lymphoma patients. However, a relative high rate of false-positive results has been reported. We report a case of a 40-year-old man with a previous history of a nodal follicular lymphoma, stage IVA, treated with R-CHOP, which showed strong 18F-FDG uptake in the Waldeyer’s tonsillar ring during his follow-up, being considered highly suspicious of relapsed lymphoma. A surgical removal of the palatine tonsils and adenoids was performed, which showed reactive follicular hyperplasia. Furthermore, bone marrow biopsy revealed absence of neoplasia. The patient is still in follow-up with no signs of recurrent lymphoma. This case illustrates that, despite the high sensitivity for the detection of recurrent lymphoma, 18F-FDG uptake should be interpreted with great caution and confirmatory studies should be performed before any therapy. |
| Keywords: | Tonsillar enlargement Reactive follicular Hyperplasia Lymphoma Chemotherapy 18F-FDG-PET |
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