The significance of isolated gallium-67 uptake in the hilar lymph nodes of an untreated lymphoma patient.

A 69-year-old woman presented with non-Hodgkin's lymphoma of the right ilioinguinal region in whom bilateral uptake of Ga-67 in hilar lymph nodes was noted on thoracic SPECT. There were no Ga-67 abnormalities elsewhere within the thorax, and a chest CT scan was also normal. The patient received radiotherapy to the inguinal region and remained in clinical remission for 28 months following treatment. She subsequently relapsed at a number of peripheral lymph node sites, but not in the chest. The authors postulate that isolated hilar uptake of Ga-67 SPECT may not be clinically significant in some untreated patients with lymphoma. This scintigraphic finding should be interpreted cautiously, particularly when other chest imaging studies remain negative.