title: Reactive tonsillar enlargement showing strong 18F-FDG uptake during the follow-up of follicular lymphoma.
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.
authors.affiliation: Department of Oral Diagnosis, Oral Pathology, Dentistry School, University of Campinas (UNICAMP), Av. Limeira, 901 Caixa Postal 52, Piracicaba, SP, 13414-903, Brazil. patyfeio@yahoo.com.br
authors.forename: Patricia do Socorro Queiroz
authors.initials: Pdo S
authors.lastname: Feio
authors.forename: Camilla Borges Ferreira
authors.initials: CB
authors.lastname: Gomes
authors.forename: Alexandre Simões
authors.initials: AS
authors.lastname: Nogueira
authors.forename: Luciana Yamamoto
authors.initials: LY
authors.lastname: Almeida
authors.forename: José
authors.initials: J
authors.lastname: Vassallo
authors.forename: Fernando Augusto
authors.initials: FA
authors.lastname: Soares
authors.forename: Oslei Paes
authors.initials: OP
authors.lastname: Almeida
authors.forename: Jorge Esquiche
authors.initials: JE
authors.lastname: León
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging*; D008224:Lymphoma, Follicular / Q000000981:diagnostic imaging*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014067:Tonsillar Neoplasms / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18