pet ct update

8/8/2019 Pet Ct Update

http://slidepdf.com/reader/full/pet-ct-update 1/19

PET CT CASE STUDY



CLINICAL HISTORY

A 60 years old male patient presented with

swelling in left side of neck since 2 months.

Biopsy done from the left cervical lymphnode :

Metastatic Squamous cell carcinoma

CT scan of neck showed enlarged cervical

lymphnodes along the great vessels of neck at

level II & III on left side. No primary malignantmass lesion was found.



Image 1



Image 2



Image 3



Image # 1 : It shows a well-definedheterogeneously enhancing FDG avid soft-tissuedensity lesion involving right tonsilar fossa (max.SUV: 5.0) with a well-defined FDG avidheterogeneously enhancing nodal mass lesionalong the great vessels of neck on left side atlevel II and III (avg. SUV: 11.9).

Images # 2 : A small well-defined FDG avidhypodense lesion is seen involving segment VIIof right lobe of liver (avg. SUV: 4.4)

Findings



Image # 3 is coronal image of whole body

PET CT which shows a well-defined

heterogeneously enhancing FDG avidsoft-tissue density lesion involving right

tonsilar fossa with a well-defined FDG avid

heterogeneously enhancing nodal mass

lesion along the great vessels of neck onleft side at level II and III.



DIAGNOSIS

Metabolically active malignant mass

lesion involving right tonsilar fossa

region with left cervical and hepatic

metastasis.



BIOPSY:

From right tonsilar fossa : Squamous cell

carcinoma.



DISCUSSION

PET CT is the modality of choice for

evaluation of metastatic disease with

unknown primary disease. PET CT

identifies primary malignant site (T-

staging), lymphnodal spread (N-staging)

and distal metastasis (M-staging). In a

single examination complete oncologicalwork up of the disease is possible.



CASE STUDY :



CLINICAL HISTORY

A male aged 54 years presented with dysphagiafor solids since 1 month.

Upper GI scopy was done & showed malignantlesion involving mid oesophagus, biopsy wastaken.

Biopsy :

Base line CT scan of thorax was done & showedmalignant mass lesion involving mid

oesophagus with mediastinal lymphadenopathy. A solitary left cervical lymphnode was found atlevel IV.



Image 1



Image 3



Image 4



FINDINGS

Image # 1 shows irregular circumferential wallthickening involving proximal lower thoracicoesophagus with luminal narrowing (max. SUV:

24.7).No evidence of loss of perioesophageal fatplanes.

Image # 2 shows an enlarged leftsupraclavicular nodes (level 1) (max. SUV:5.31).

Image # 3 shows an enlarged left gastric node(level 17) (max. SUV: 6.43).



Image # 4 is coronal image of whole body

PET CT shows FDG avid oesophageal

malignant wall thickening with mediastinal,

left cervical and left gastric lymphnodes.



DIAGNOSIS

Metabolically active malignant wall

thickening involving proximal lower

thoracic oesophagus with mediastinal,

left gastric and left supraclavicular

metastatic lymphadenopathy.

According to TNM classification: -

T2N1M1b ± Stage IV B.

pet ct update

Documents