Clinical History
59 year old gentleman with newly diagnosed nasopharyngeal carcinoma. PET/CT for staging.
Findings
A moderately FDG-avid focus is noted in the left Fossa of Rosenmuller of the nasopharynx (maxSUV 7.5). No abnormal FDG-avid focus is seen in the parapharyngeal spaces, pterygopalatine fossae, infratemporal fossae, clivus and the rest of the skull base. The paranasal sinuses and mastoids are clear. No abnormal FDG-avid focus is seen in the cerebral hemispheres or cerebellum.
Moderately FDG-avid left retropharyngeal node (maxSUV 9.4), left level II, III and V nodes (largest measuring 18x12mm, maxSUV 13.2) and right level II and III nodes are present. No FDG-avid supraclavicular or mediastinal nodes are noted. The non FDG-avid subcentimeter right paratracheal nodes are more in keeping with reactive nodes.
No FDG-avid focus or nodule is noted in the lungs. Linear atelectasis is seen in the right middle lobe and left lingular segment. No pleural effusion or pericardial effusion is noted.
The diffuse gastric activity could be physiological in origin or due to mild gastritis. There are no FDG-avid intra-abdominal or retroperitoneal nodes. No abnormal FDG-avid focus is noted in the liver, spleen, pancreas or adrenal glands.
The bone marrow shows normal physiological distribution of FDG activity.
Clinical Impression
A FDG-avid tumoural focus is noted in the left Fossa of Rosenmuller of the nasopharynx.
FDG-avid left retropharyngeal and bilateral jugular/cervical nodal metastases are seen.
No FDG-avid distant metastases are noted.
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