F-18-FDG-PET in a patient with Hashimoto's thyroiditis and MALT lymphoma recurrence of the thyroid.

Wien Med Wochenschr

Department of Nuclear Medicine and Special Endocrinology, PET-Center, Klagenfurt State Hospital, St. Veiterstrasse 47, A-9020 Klagenfurt.

Published: July 2003

AI Article Synopsis

  • An 86-year-old male was diagnosed with MALT lymphoma in his thyroid after surgery, with adjacent tissue showing Hashimoto's thyroiditis.
  • A follow-up showed a second nodule, prompting an F-18-FDG-PET scan which indicated widespread hypermetabolism in the left lobe, but no distinction between the nodule and adjacent tissue.
  • This case suggests that F-18-FDG-PET imaging is not effective for assessing MALT lymphoma in patients with concurrent Hashimoto's thyroiditis.

Article Abstract

We report on the case of a 86-year-old male patient with a rapidly growing nodule within the right lobe of the thyroid gland, which after hemithyroidectomy, turned out to be a mucosa-associated lymphoid tissue (MALT) lymphoma of the thyroid gland. In addition, Hashimoto's thyroiditis was reported in the thyroid tissue adjacent to the MALT lymphoma. During follow-up a second nodule emerged within the left lobe and, because of evidence of MALT lymphoma recurrence, F-18-FDG-PET was performed. F-18-FDG-PET imaged a clearly increased accumulation within the whole left lobe and isthmus. Thus, no differences in the degree of hypermetabolism could be imaged between the nodule and the adjacent thyroid tissue. To our knowledge, this is the first report about F-18-FDG-PET in a patient with MALT lymphoma of the thyroid. Literature search revealed only a few cases of MALT lymphomas in locations other than the thyroid gland that were studied with F-18-FDG-PET. In no case was F-18 FDG accumulation seen in the MALT lesions. However, clear F-18 FDG accumulation was reported in some patients with Hashimoto's thyroiditis. It is concluded that the intensive F-18-FDG accumulation within the whole left lobe and isthmus of the presented case was due to the coexisting Hashimoto's thyroiditis. Consequently, F-18-FDG-PET imaging does not seem to be indicated in a patient with MALT lymphoma and known Hashimoto's thyroiditis in order to evaluate the status of the MALT lymphoma.

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http://dx.doi.org/10.1046/j.1563-258x.2003.02007.xDOI Listing

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