Clinical History
Case of newly diagnosed ca oesophagus for staging with PET/CT.
Findings
An intensely FDG-avid mass (maxSUV 20.0) is present along the mid and lower thoracic portion as well as the intra-abdominal portion of the oesophagus and this extends inferiorly to involve the gastro-oesophageal junction and the adjacent lesser curve of the stomach.
There are several mild to moderately FDG-avid para-oesophageal nodes, subcarinal node (maxSUV 12.5), peri-gastric nodes, gastrohepatic nodes, peri-coeliac node, peri-pancreatic nodes, peri-SMA node, retrocrural node, paracaval nodes, aortocaval nodes and para-aortic nodes.
The bilateral FDG-avid parotid nodules are more likely to represent inflammatory intra-parotid nodes. The mildly FDG-avid bilateral jugular nodes could also be inflammatory rather than metastatic in origin.
No ascites or FDG-avid peritoneal nodules are noted. No abnormal FDG-avid focus is noted in the liver, spleen, pancreas or adrenal glands.
No FDG-avid focus is seen in the lungs. The subcentimeter nodule in the right upper lobe is too small to be accurately resolved on PET and is indeterminate on CT. Mild scarring is seen in the left upper lobe. No pleural effusion or pericardial effusion is noted.
The bone marrow shows normal physiological distribution of FDG activity.
Clinical Impression
A FDG-avid oesophageal tumoural mass with involvement of the gastro-oesophageal junction and the adjacent lesser curve of the stomach is demonstrated.
Extensive FDG-avid nodal metastases are present as described.
There are no other FDG-avid metastatic foci noted elsewhere.
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