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Reactive Tonsillar Enlargement Showing Strong 18F-Fdg Uptake During the Follow-Up of Follicular Lymphoma

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Abstract

The 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has become a standard procedure for the diagnosis, staging, and restaging in lymphoma patients. However, a relative high rate of false-positive results has been reported. We report a case of a 40-year-old man with a previous history of a nodal follicular lymphoma, stage IVA, treated with R-CHOP, which showed strong 18F-FDG uptake in the Waldeyer’s tonsillar ring during his follow-up, being considered highly suspicious of relapsed lymphoma. A surgical removal of the palatine tonsils and adenoids was performed, which showed reactive follicular hyperplasia. Furthermore, bone marrow biopsy revealed absence of neoplasia. The patient is still in follow-up with no signs of recurrent lymphoma. This case illustrates that, despite the high sensitivity for the detection of recurrent lymphoma, 18F-FDG uptake should be interpreted with great caution and confirmatory studies should be performed before any therapy.

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Authors and Affiliations

  1. Department of Oral Diagnosis, Oral Pathology, Dentistry School, University of Campinas (UNICAMP), Av. Limeira, 901 Caixa Postal 52, Piracicaba, SP, 13414-903, Brazil

    Patricia do Socorro Queiroz Feio, Camilla Borges Ferreira Gomes, Luciana Yamamoto Almeida & Oslei Paes Almeida

  2. School of Dentistry, Federal University of Ceará, Sobral Campus, Rua Stanislau Frota s/n - antiga fábrica de tecidos Centro, Sobral, CE, 62010-560, Brazil

    Alexandre Simões Nogueira

  3. Laboratory of Investigative and Molecular Pathology – CIPED, State University of Campinas Medical School (FCM/UNICAMP), Rua Tessália Vieira de Camargo, 126. Cidade Universitária “Zeferino Vaz”, Campinas, SP, 13083-887, Brazil

    José Vassallo

  4. Department of Pathology, Cancer Educational and Research Center Hospital AC Camargo, Rua Prof. Antônio Prudente, 109 - 1º andar Anatomia Patológica, Liberdade, São Paulo, SP, 01509-010, Brazil

    Fernando Augusto Soares

  5. Department of Morphology, Stomatology and Physiology, Oral Pathology, Dentistry School, University of São Paulo (USP), Av. do Café s/n Monte Alegre, Ribeirão Preto, SP, 14040-904, Brazil

    Jorge Esquiche León

Authors
  1. Patricia do Socorro Queiroz Feio
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  2. Camilla Borges Ferreira Gomes
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  3. Alexandre Simões Nogueira
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  4. Luciana Yamamoto Almeida
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  5. José Vassallo
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  6. Fernando Augusto Soares
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  7. Oslei Paes Almeida
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  8. Jorge Esquiche León
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Correspondence to Patricia do Socorro Queiroz Feio.

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Feio, P.d.S.Q., Gomes, C.B.F., Nogueira, A.S. et al. Reactive Tonsillar Enlargement Showing Strong 18F-Fdg Uptake During the Follow-Up of Follicular Lymphoma. Head and Neck Pathol 7, 258–262 (2013). https://doi.org/10.1007/s12105-012-0400-5

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  • DOI: https://doi.org/10.1007/s12105-012-0400-5

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