Presentation
Staging scan for a pancreatic lesion. There are no head and neck symptoms.
Patient Data
18-FDG PET-CT was performed for pancreatic lesion staging. There is asymmetric, moderate to intense, FDG uptake present in the left base of the tongue region, associated with mild partial effacement of the left epiglottic vallecula on the low-dose CT. There is also mildly asymmetric moderate uptake in the left palatine tonsil. Clinical correlation and direct visualization with a possible biopsy are recommended. Left tonsil SUVmax 7.6.
Case Discussion
On ENT review of the patient 2 months later, there was no evidence of superficial changes to the tonsil on fine nasal endoscopy and no palpable neck masses. Given the clinical course, the FDG avidity seen on the PET scan is considered to have been inflammatory/reactive. Therefore, no biopsy was performed.
Key learning point: incidental FDG avidity discrepancy between lymphoid tissue areas merits clinical and/or radiological follow-up.
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