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World J Radiol. Dec 28, 2014; 6(12): 890-894
Published online Dec 28, 2014. doi: 10.4329/wjr.v6.i12.890
Postoperative reactive lymphadenitis: A potential cause of false-positive FDG PET/CT
Yiyan Liu
Yiyan Liu, Nuclear Medicine Service, Department of Radiology, Rutgers University Hospital, Newark, NJ 07103, United States
Author contributions: Liu Y solely contributed this work.
Correspondence to: Yiyan Liu, MD, PhD, Nuclear Medicine Service, Department of Radiology, Rutgers University Hospital, 150 Bergen Street, H141, Newark, NJ 07103, United States. liuyl@njms.rutgers.edu
Telephone: +1-973-9726022 Fax: +1-973-9726954
Received: April 30, 2014
Revised: July 1, 2014
Accepted: October 14, 2014
Published online: December 28, 2014
Abstract

A wide variety of surgical related uptake has been reported on F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) scan, most of which can be differentiated from neoplastic process based on the pattern of FDG uptake and/or anatomic appearance on the integrated CT in image interpretation. A more potential problem we may be aware is postoperative reactive lymphadenitis, which may mimic regional nodal metastases on FDG PET/CT. This review presents five case examples demonstrating that postoperative reactive lymphadenitis could be a false-positive source for regional nodal metastasis on FDG PET/CT. Surgical oncologists and radiologists should be aware of reactive lymphadenitis in interpreting postoperative restaging FDG PET/CT scan when FDG avid lymphadenopathy is only seen in the lymphatic draining location from surgical site.

Keywords: Lymphadenitis, F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography, False-positive, Lymphadenopathy

Core tip: On restaging F18-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography for oncologic patients, a potential problem we may be aware is postoperative reactive lymphadenitis, which may mimic regional nodal metastases. The size and intensity of FDG uptake of the lymph nodes cannot be reliably used for differentiation of reactive lymphadenitis from regional nodal metastasis. Surgical oncologists and radiologists should be aware of reactive lymphadenitis when FDG avid lymphadenopathy is only seen in the lymphatic draining location from surgical site.