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18FDG-PET/CT Specificity for the Detection of Lymphoma Recurrence in the Tonsils.
West, Jonathan D; Kim, Mary E; Lapalma, Dorian M; Vergara-Lluri, Maria; Conti, Peter; Chambers, Tamara N; Swanson, Mark S.
Afiliação
  • West JD; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Kim ME; Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Lapalma DM; Division of Neuroradiology, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Vergara-Lluri M; Hematopathology Section, Department of Pathology, University of Southern California, Los Angeles, California, USA.
  • Conti P; Division of Neuroradiology, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Chambers TN; USC Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
  • Swanson MS; USC Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
OTO Open ; 5(4): 2473974X211059081, 2021.
Article em En | MEDLINE | ID: mdl-34805720
OBJECTIVE: In patients with a history of lymphoma who demonstrate palatine tonsil uptake on posttreatment PET/CT (positron emission tomography/computed tomography), tonsillectomy is often performed to evaluate for lymphoma recurrence. However, predictive clinical and imaging factors for true tonsil recurrence in this setting are not well established; this will be explored herein. STUDY DESIGN: Retrospective case series. SETTING: Patients treated at a tertiary medical center from January 2008 to May 2020. METHODS: Chart review was performed on all patients with a history of treated lymphoma in clinical remission who presented for evaluation of abnormal PET/CT imaging findings and subsequently underwent tonsillectomy. RESULTS: Among 15 patients who met inclusion criteria, 14 had benign findings on surgical pathology, yielding a false-positive rate of 93%. The patient with malignancy was identified on biopsy after inconclusive surgical pathology and is the only documented case of recurrence in this specific patient population throughout the literature. The patient presented with B symptoms, irregularly shaped tonsils, increased lymph node activity on PET/CT, and uptrending bilateral tonsil activity but with one of the lowest maximum standardized uptake values of the cohort. The singular distinguishing feature for the patient with recurrent disease was a prior tonsil biopsy suspicious for recurrence, which prompted the otolaryngology referral. CONCLUSION: PET/CT lacks specificity in identifying lymphoma recurrence in the oropharynx. Clinical and radiographic features that were previously considered concerning for recurrence are most likely not indicative of malignancy in this patient population. Our findings call into question whether tonsillectomy should be routinely performed in this patient population.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Prognostic_studies Idioma: En Revista: OTO Open Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Prognostic_studies Idioma: En Revista: OTO Open Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos