Heidi Wassef

Primary spinal epidural non-Hodgkin lymphoma demonstrated by FDG PET/CT.

We report the F-18 fluorodeoxyglucose positron emission tomography/computed tomography appearance of a biopsy-proven primary epidural non-Hodgkin lymphoma involving the lower cervical and upper thoracic spine with a small hypermetabolic right middle lobe nodule in a 33-year-old man. The HIV-positive patient presented with mid- to low back pain for several days, which progressed to lower extremity weakness and urinary retention. Primary spinal epidural non-Hodgkin lymphoma is a rare form of malignancy, constituting approximately 0.1% to 3.3% of all lymphomas. In our case, the primary tumor appears as an intensely hypermetabolic soft-tissue mass involving the posterior epidural space from C6 through T9 levels.

FDG PET/CT imaging in granulomatous changes secondary to breast silicone injection.

An 81-year-old woman with history of silicone injection and saline bag implants in both breasts was diagnosed over 30 years later with lobular carcinoma in her right breast and underwent right mastectomy. She was referred to our institution for a restaging PET-CT examination. The PET-CT images showed multiple lobulated/nodular, hypermetabolic, soft-tissue masses, and scattered calcifications involving the right chest wall, left breast, and bilateral axillary regions. Biopsy was consistent with silicone-related granulomatous tissue. The largest soft-tissue mass in the

Renal metastasis from primary colon cancer on FDG PET-CT.

We report the PET-CT appearance of a metastasis from a primary colon cancer to the right kidney in an 84-year-old woman with a history of moderately differentiated adenocarcinoma of the cecum. The patient underwent right hemicolectomy and chemotherapy. Restaging PET-CT study, 4 months after her last chemotherapy, demonstrates a hypermetabolic soft-tissue mass in the inferior pole of the right kidney. The patient subsequently had a right partial nephrectomy. The pathology was consistent with metastatic colonic adenocarcinoma. Renal metastasis from primary colon cancer is very rare.

F-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in left thigh intramuscular myxoma.

We report F-18 FDG PET-CT appearance of biopsy-proven intramuscular myxoma (IM) in a 69-year-old woman who presented with a left thigh mass. The tumor appears as a well-defined, hypodense mass with thin septation on CT images and mild uptake on PET images. IMs are rare benign myxoid tumors characterized by a paucity of cells, diminished vascularity, and minimal mitotic figures. They most often present as slow-growing, painless, deep-seated intramuscular masses. The mainstay of treatment is surgical resection.

Multi-level lumbar Baastrup disease on F-18 FDG PET-CT.

Abstract:We report the positron emission tomography-computed tomography appearance of Baastrup disease in the L2–L5 interspinous ligament region in a 79-year-old woman with a history of moderately differentiated lobular breast carcinoma. The patient is status post bilateral mastectomies, on tamoxife

18F-FDG PET/CT appearance of metastatic brachial plexopathy involving epidural space from breast carcinoma.

Patient is a 74-year-old woman with a history of breast carcinoma and known metastatic brachial plexopathy and pulmonary and mediastinal nodal involvement. She had bilateral mastectomies 5 years ago and is currently on chemotherapy. A 6-month follow-up PET/CT study demonstrated no significant interval change in intensity of the previously evident hypermetabolic activity of the brachial plexopathy. However, this activity has extended superiorly and medially involving the right lateral aspect of the epidural space at the C5-6 level, consistent with epidural involvement. In addition, the hypermetabolic activity of the pulmonary and mediastinal metastases has also increased, consistent with interval progression of the disease.

Malignant transformation of retroperitoneal inflammatory pseudotumor to undifferentiated high-grade pleomorphic sarcoma on FDG PET/CT.

We report FDG PET/CT appearance of malignant transformation of retroperitoneal inflammatory pseudotumor to pleomorphic sarcoma in a 78-year-old woman. The patient was diagnosed with left retroperitoneal pseudotumor in 2007. She subsequently suffered from recurrent disease and chronic osteomyelitis in the L5 vertebral body in July 2008, status post surgical excision. In November 2009, after the patient developed left groin pain, MRI study of lumbosacral spine and whole-body PET/CT study demonstrated 2 hypermetabolic soft-tissue masses originating from the L5 surgical bed. These masses were subsequently resected and were consistent with pleomorphic sarcoma. Malignant transformation of retroperitoneal pseudotumor to pleomorphic sarcoma is extremely rare.

Cosmetic-related Changes on 18f-fdg Pet/ct

We present 4 cases of cosmetic-related changes on 18F-FDG PET/CT. These cases represent post-treatment changes from facial juvederm injection, silicone injection in the chest wall and gluteal areas, paraffin injection in the gluteal region, and liposuction. Recognition of cosmetic-related changes and their appearance on PET and CT will help to avoid potential false-positive interpretations.

Recurrent ovarian carcinoma presenting as a solitary sternal metastasis on FDG PET/CT.

We report the positron emission tomography/computed tomography appearance of solitary sternal metastasis from primary ovarian carcinoma in a 65-year-old woman who underwent surgery followed by chemoradiation treatment 3 years earlier. Restaging positron emission tomography/computed tomography study demonstrates an intensely active destructive lesion involving the entire sternum (maximum standard uptake value: 4.7) with a photopenic soft tissue mass component in the center of the sternum protruding anteriorly suggestive of necrosis. This sternal lesion was subsequently biopsied and pathology revealed metastatic disease from the primary ovarian tumor for which the patient had received chemoradiation therapy. Bone involvement in ovarian cancer is relatively rare and even rarer in the sternum.

F-18 FDG PET-CT imaging in recurrent cerebral gliosarcoma.

We report the F-18 FDG PET-CT appearance of recurrent gliosarcoma (GS) with extracranial extension in a 47-year-old man who underwent surgical resection of a right frontal GS 5 months earlier. F-18 FDG PET demonstrated moderate uptake in the recurrent disease. GS is a very rare, biphasic primary neoplasm of the central nervous system, composed of glioblastoma multiforme mixed with a sarcomatous component. It occurs in adults of middle age and carries a poor prognosis. The median survival reported is less than a year. The results suggest that F-18 FDG PET imaging may be useful in detecting recurrent GS.