Ga-PSMA PET/CT is increasingly used to evaluate recurrent prostatic malignancy due to its high specificity. A 75-year-old man with a previous history of treated prostate cancer 3 years earlier presented with rising prostate-specific antigen (PSA) level and underwent Ga-PSMA PET/CT which demonstrated a PSMA-avid focus in the neck of the pancreas. Triple-phase abdominal CT demonstrated enhancement in the arterial phase and to a lesser extent the venous phase of a soft tissue mass in the neck of the pancreas. Cytological and histopathological examination of the soft tissue mass confirmed a low-grade pancreatic neuroendocrine tumor.
A 50-year-old man with recently diagnosed prostate cancer was referred for Ga-prostate-specific membrane antigen (PSMA) PET/CT with elevated prostate-specific antigen. PET/CT demonstrated increased PSMA uptake in an undisplaced transverse fracture of the L1 vertebral body. This case illustrates that PSMA uptake can occur in a transverse vertebral body fracture and is a benign cause of PSMA uptake.
A 68-year-old man with treated prostate cancer 3 years earlier and small cleaved B-cell follicular lymphoma diagnosed 1 year prior and monitored clinically with no active intervention ("watch and wait" approach) was referred for Ga-prostate-specific membrane antigen (PSMA) PET/CT with rising prostate-specific antigen level. PET/CT demonstrated diffuse PSMA uptake in the prostate (SUVmax 3.6) and multiple PSMA-avid nonenlarged lymph nodes. Moderate PSMA uptake (SUVmax 4.7) was also noted in an enlarged right inguinal lymph node (SUVmax 4.7), which on core biopsy confirmed small cleaved B-cell follicular lymphoma.
A 64-year-old man with a history of metastatic clear cell renal cell cancer was referred for progress Ga-DOTATATE PET/CT imaging. Ga-DOTATATE PET/CT imaging demonstrated increased DOTATATE uptake (SUVmax 13.8) in the left thigh localized to a soft tissue lesion. Cytopathology of the resected lesion was in keeping with a clear cell renal cell cancer metastasis. This case illustrates that Ga-DOTATATE accumulation in a soft tissue lesion can be due to a clear cell renal cell cancer metastasis.
A 64-year-old man with a lesion of the pancreatic tail was referred for Ga-DOTATATE PET/CT imaging. His medical history included previous metastatic clear cell renal cell cancer. Ga-DOTATATE PET/CT demonstrated increased DOTATATE uptake (SUVmax 10.5) in a pancreatic tail lesion. Histopathology of the resected lesion confirmed clear renal cell cancer metastasis. This case illustrates that clear cell renal cancer metastasis can demonstrate Ga-DOTATATE accumulation.
A 66-year-old man with recently diagnosed prostate cancer (Gleason score 9) was referred for Ga-prostate-specific membrane antigen (PSMA) PET/CT with prostate-specific antigen level of 7.5 μg/L. PET/CT demonstrated increased PSMA uptake (SUVmax 4.7) in a soft tissue density in the left adductor compartment. MRI and cytopathology of the biopsied soft tissue density was compatible with a peripheral nerve sheath tumor. This case illustrates that PSMA uptake can occur in a peripheral nerve sheath tumor and should be taken into consideration as a benign cause of PSMA uptake.
A 73-year-old man was referred for F-FDG PET/CT study for staging of biopsy-proven pancreatic adenocarcinoma. The scan demonstrated focal intense FDG uptake in the pancreatic head, localizing the primary tumor. Additional moderate diffuse uptake was seen throughout the pancreas, suggestive of acute pancreatitis. Concurrent diagnostic CT showed diffuse pancreatic hypoenhancement consistent with edema. Serum lipase level was elevated, confirming a diagnosis of acute pancreatitis.
Sacral perineural cysts are also known as Tarlov cysts. A 58-year-old man with suspected intracranial hypotension was evaluated with Tc-DTPA radionuclide cisternography. Radionuclide planar and SPECT/CT cisternography revealed Tc-DTPA uptake in sacral lesions. Spine MRI confirmed Tarlov cysts at the S1 and S2 levels.
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