Patient: Afaf, Mohammad, Abd El-Halem KHALIL

ID: FL1079007 DOB: 12/15/1963

Age/Gender: 53Y, F Procedure: PET CT Study Date: 10/24/2017 12:26:51 PM

Order #: FL1111981

Report Status: Preliminary

Whole Body F18- FDG PET/CTstudy

Clinical history:-

54 year- old patient, accidentally discovered multiple enlarged abdominal lymph nodes and hepato-
splenomegally.

Type of the study: initial study.

Procedure:

Radiopharmaceutical: 18F FDG, 8.5 mCi I.V.

Blood glucose level at time of 18F-FDG injection: 103 mg/dL .

Time from 18F-FDG injection to scan: 56 min

Technique :MDCT diagnostic post contrast examination was taken after I.V. non-ionic contrast
administration for attenuation correction anatomic localization followed by PET images from the skull
vault to the mid thigh were obtained.

Images of CT and corresponding functional PET images are taken in axial, coronal and sagittal planes.

Patient's height: 165 cm patient's weight: 91 kg

SUV average of reference hepatic activity = 2.7

PET/CT FINDINGS:-

Head and Neck:

Multiple metabolically non active FDG avid lymph nodes are seen involving left upper cervical group II
measuring 1.1 cm.

The brain exhibited normal FDG bio-distribution

Physiologic FDG uptake is seen in the oropharynx, salivary glands, and larynx.
No focal or diffuse thyroid gland FDG uptake could be elicited.

Chest:

Multiple metabolically active FDG avid mediastinal lymph nodes are seen involving:

Left supraclavicular LN , with SUV max

Anterior vascular LN , measures 3.3 x 2.5 cm with SUV max

Peri esophageal LN, measures 1 cm with SUV max

Metabolic active FDG lung nodule in the left apical segment with SUV max

Both lung parenchyma shows ground glass pattern mainly in both lower lobe with emphysematous
changes.

There are no pleural or pericardial abnormalities.

Physiologic FDG uptake is noted in the myocardium with massive cardiomegaly.

Abdomen and Pelvis:

The liver is enlarged in size with diffuse low attenuation value no avid hepatic focal lesion.

Spleen is enlarged in size with multiple infarcts areas with inhomogenous diffuse FDGdistribution.

GB stone .

Multiple metabolically active FDG avid lymph nodes are seen amalgamated at:

Splenic hilum ( 3.3 cm with SUV max

No evidence of lymphomatous infiltration of the kidneys and pancreas with left renal simple cyst.

There are no FDG avid adrenal nodules.

No evidence of FDG avid peritoneal nodules

Physiologic FDG excretion is seen in the kidneys and bladder.

Mild pelvic collection.

Musculoskeletal:

Hyperactive bone marrow changes with no avid metabolic osseous lesion.

Conclusion:

initial PET/CT revealed positive study for multiple metabolically active FDG avid supra and infra-
diaphragmatic nodal lesions, as well as splenic and marrow involvement as described.

Thanks for referral;

DR, SHAHIRA AHMED, MD

Radio-diagnosis department ,

Nuclear Medicine unit ASUH