Correlation of Tissue Biopsy and Fine Needle Aspiration Cytology with Positron Emission Tomography Results

F-18-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) scans are positive in any condition which increases metabolism in a mass or tissue and are therefore not specific for neoplastic conditions. The use of an SUV cutoff value of 2.5 may not always help discriminate between benign and malignant cases. For a practicing cytopathologist doing adequacy checks during an image-guided procedure, it may be of value to be aware that elevated SUV values are not always indicative of a malignant process, and vice versa

Metastatic Cecal Adenocarcinoma presenting as acute appendicitis

This case report details the findings of metastatic colon cancer in an older male patient who initially presented with signs and symptoms of acute appendicitis. The patient underwent routine CT (Computed Tomography) imaging for diagnostic evaluation of appendicitis. Subsequently, the patient was found to have findings consistent with acute appendicitis secondary to obstruction from a cecal mass with evidence of hepatic and pulmonary metastases. This case report demonstrates the radiological findings of acute appendicitis secondary to metastatic colorectal disease and highlights the importance of considering underlying malignancy in cases of appendicitis occurring in older individuals

Direct Spread of Primary Testicular Lymphoma along the Gonadal Vessels Detected on F-18 Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Imaging

A 63-year-old male presented with left scrotal swelling and the ultrasound showed a large heterogeneous mass consistent with a testicular malignancy. The patient underwent left-sided orchiectomy which showed diffuse large B-cell lymphoma. The patient was then referred for whole-body F-18 fluorodeoxyglucose positron-emission tomography/computed tomography (FDG PET/CT) imaging which showed multiple hypermetabolic foci extending along the left inguinal canal to the retroperitoneum and the left perinephric space, suggesting direct contiguous spread of the tumor along the gonadal vessels, a form of metastasis unique to primary testicular lymphoma, and demonstrated for the first time on FDG PET/CT imaging

Focal FDG Activity in the Region of Right Atrium: Coregistered CT Identifies Three Benign Etiologies

We present the whole body FDG PET-CT images on 3 different patients with benign focal activity in the region of the right atrium. Co-registered CT correctly identified the cause of focal FDG activity as: right atrial appendage, lipomatous hypertrophy of the interatrial septum, and catheter-related activity. Although all these have been reported separately in the literature, we are presenting them together to emphasize the importance of recognizing the benign causes of FDG uptake in the region of right atrium and the role of co-registered CT in improving the accuracy and specificity of the FDG PET

FDG PET Appearance of “Cannonball” Pulmonary Metastases

AbstractWe present the case of a 67-year-old woman with a recent tissue diagnosis of endometrial cancer whose FDG PET scan exhibited multiple hypermetabolic foci through out both the lungs. Contemporaneously acquired conventional radiolographs showed parenchymal nodules that demonstrated the classic “cannon ball” appearance of pulmonary metastases. Pulmonary metastasis from an endometrial primary is a rare event, as are the presence of pulmonary findings at the time of initial staging. Thus, this case demonstrates rare, and yet, distinctive aspects of the disease presentation and image correlation across the various imaging modalities