title: Lymphadenopathy resulting from acute toxoplasmosis mimicking relapse of non-Hodgkin's lymphoma on fluorodeoxyglucose positron emission tomography/computed tomography.
abstract: We report a case documenting fluorodeoxyglucose (FDG) accumulation in cervical, supraclavicular and axillary lymph nodes resulting from acute toxoplasmosis. A 50-year-old Indian female with history of non-Hodgkin's lymphoma (NHL) of left breast, postchemotherapy status, was found to have hypermetabolic right cervical, supraclavicular and axillary lymph nodes on a surveillance FDG positron emission tomography/computed tomography (PET/CT) scan. Her previous two PET/CT scans were unremarkable with no evidence of metabolically active disease. Therefore, a differential diagnosis of relapse of NHL versus infectious/inflammatory pathology was raised in the report. Biopsy of axillary lymph node demonstrated features characteristic of toxoplasmosis. The serological test results were also compatible with acute toxoplasmosis infection. Infective and inflammatory diseases are known to accumulate FDG, resulting in false positives for malignancy. This case demonstrates lymph nodal toxoplasmosis as a potential cause of false positive FDG PET/CT findings in patients with known malignancy and highlights the importance of histopathological and laboratory correlation for the accurate interpretation of FDG PET/CT scans.
authors.affiliation: Department of Nuclear Medicine and PET-CT, Jaslok Hospital and Research Centre, Worli, India. drprathamj@gmail.com
authors.forename: Prathamesh
authors.initials: P
authors.lastname: Joshi
authors.forename: Vikram
authors.initials: V
authors.lastname: Lele
authors.forename: Pravin
authors.initials: P
authors.lastname: Mahajan
mesh_terms: D001365:Axilla; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014123:Toxoplasmosis / Q000150:complications* / Q000000981:diagnostic imaging*
chemical_list: D019788:Fluorodeoxyglucose F18