Primary Breast Lymphoma Detected by 18F-FDG and 68Ga-DOTA-FAPI-04 PET/CT

Abstract

Primary breast lymphoma is a rare form of extranodal lymphoma. We report 18 F-FDG and 68 Ga-DOTA-FAPI-04 PET/CT findings of breast lymphoma in a 60-year-old woman. Both breast ultrasound and mammogram showed a mass in the right breast and suggested that the mass might be a malignant tumor. She was referred for an 18 F-FDG PET/CT scan and subsequently recruited in our 68 Ga-DOTA-FAPI-04 PET/CT trial. Both scans revealed the breast mass with intense tracer uptake. Biopsy and immunohistochemical examinations of the mass confirmed the diagnosis of diffuse large B-cell lymphoma.

Comparison of 68Ga-FAPI PET and 18F-FDG PET Findings in a Patient With Bilateral Breast Cancer of 2 Different Histopathologies

“…Preliminary studies have suggested 68 Ga-FAPI PET to be superior to 18 F-FDG PET in detecting primary as well as metastatic lesions in breast cancer 5,6 . FAPI avidity in noncarcinoma breast malignancies have also been demonstrated 7,8 . However, to the best of our knowledge, this is the first case where both FAPI and FDG PET findings of tubulolobular breast cancer have been discussed in a single patient.…”

“…5,6 FAPI avidity in noncarcinoma breast malignancies have also been demonstrated. 7,8 However, to the best of our knowledge, this is the first case where both FAPI and FDG PET findings of tubulolobular breast cancer have been discussed in a single patient. This case highlights the potential superiority of 68 Ga-FAPI PET over FDG PET in staging breast cancer, especially in the subtypes with a high proportion of fibroblastic stroma.…”

18F-FAPI-42 Versus 18F-FDG PET/MRI in a Case of Primary Peripheral T-Cell Lymphoma of the Skeletal Muscles

“…10 FAPI PET is useful for detecting fibroblast activation protein expression in stromal cells of the lymphoma lesions. [10][11][12][13][14][15] High-grade lymphoma tend to show higher FAPI uptake than low-grade lymphoma. 11 FAPI PET may be inferior to FDG PET in detecting lymphoma lesions.…”

Complex Fibroadenoma Mimicking Breast Cancer on 68Ga-FAPI-04 and 18F-FDG PET/CT

“…1-4 68 Ga-FAPI PET/CT has been positive in many primary breast malignancies and may also be positive in many nonmalignant lesions or diseases. [5][6][7][8][9][10][11][12] Although varying levels of FAP positivity are observed in breast cancer, it has been reported that little or no expression is detected in epithelial cells of simple fibroadenoma, benign proliferative breast disease, and normal breast. 13 Similarly, in the study of Lan et al, it was determined that 68 Ga-FAPI-04 PET/CT did not show a significantly higher SUV max than 18 F-FDG PET/CT for all 145 nononcological lesions.…”

“…Fibroadenomas include histological variants that exhibit distinct histological features and variations in their clinicopathological features, including cellular, juvenile, and complex fibroadenomas. Various radiopharmaceuticals have been reported to show varying degrees of uptake in fibroadenoma.1-4 68 Ga-FAPI PET/CT has been positive in many primary breast malignancies and may also be positive in many nonmalignant lesions or diseases [5][6][7][8][9][10][11][12]. Although varying levels of FAP positivity are observed in breast cancer, it has been reported that little or no expression is detected in epithelial cells of simple fibroadenoma, benign proliferative breast disease, and normal breast 13.…”