William Makis

• MD
• Nuclear Medicine Oncologist at Cross Cancer Institute

Myocarditis, typically manifesting as myopericarditis, is among the serious cardiac consequences observed over the course of the COVID-19 pandemic. We performed a comprehensive, evidence-based literature synthesis of findings from clinical trial data reanalyses, post-marketing surveillance, large observational studies, and other diverse research so...

PUBLISHED IN: Science, Public Health Policy and the Law (https://publichealthpolicyjournal.com/a-systematic-review-of-autopsy-findings-in-deaths-after-covid-19-vaccination/) Background: The rapid development of COVID-19 vaccines, combined with a high number of adverse event reports, have led to concerns over possible mechanisms of injury including...

Background: The rapid development of COVID-19 vaccines, combined with a high number of adverse event reports, have led to concerns over possible mechanisms of injury including systemic lipid nanoparticle (LNP) and mRNA distribution, Spike protein-associated tissue damage, thrombogenicity, immune system dysfunction, and carcinogenicity. The aim of t...

COVID‐19 vaccines have been linked to myocarditis, which, in some circumstances, can be fatal. This systematic review aims to investigate potential causal links between COVID‐19 vaccines and death from myocarditis using post‐mortem analysis. We performed a systematic review of all published autopsy reports involving COVID‐19 vaccination‐induced myo...

Background: COVID-19 vaccines have been linked to myocarditis which in some circumstances can be fatal. This systematic review aims to investigate potential causal links between COVID-19 vaccines and death from myocarditis using post-mortem analysis. Methods: We performed a systematic review of all published autopsy reports involving COVID-19 vacci...

Less than a year after the global emergence of the coronavirus SARS-CoV-2, a novel vaccine platform based on mRNA technology was introduced to the market. Globally, around 13.38 billion COVID-19 vaccine doses of diverse platforms have been administered. To date, 72.3% of the total population has been injected at least once with a COVID-19 vaccine....

A 60-year-old female with no significant medical history presented with hematuria. A computed tomography (CT) scan revealed extensive lymphadenopathy with hypodensities in the liver and spleen, and she was referred for an 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/CT (PET/CT) study to assess for malignancy of unknown primary. PET...

A 65-year-old male patient with a one year history of liver transplantation was referred for an 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to rule out post transplant lymphoproliferative disease. Multiple foci of intense abnormal 18F-FDG uptake were seen in the transplanted liver which were conc...

A 67-year-old female patient with no prior history of benign thyroid disease was diagnosed with primary thyroid lymphoma and was staged with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). She was treated with chemotherapy and external beam radiation therapy, and a follow-up PET/CT showed significan...

A 49-year-old male patient with a prior history of poor compliance with medical appointments was referred for an 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for the staging of a rectal squamous cell carcinoma. The PET/CT showed unilateral diffuse skeletal muscle 18F-FDG uptake as well as bilatera...

Objective: The purpose of the current study is to examine the incidence and clinical significance of unexpected focal uptake of 18F-fluorodeoxyglucose (18F-FDG) on positron emission tomography/computed tomography (PET/CT) in the thyroid gland of oncology patients, the maximum standardized uptake value (SUVmax) of benign and malignant thyroid incide...

Objective: The aim of this study was to evaluate the clinical significance of incidental focal uptake of 18F-fluorodeoxyglucose (18F-FDG) on positron emission tomography/computed tomography (PET/CT) in the prostate glands of cancer patients. Methods: A retrospective review of 3122 consecutive male patients who underwent 18F-FDG PET/CT studies with...

A 60 year old woman who presented with multiple small subcutaneous nodules in the upper back and arms, was referred for an [18F] fluoro-2-deoxy-D-glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) after histological evaluation revealed metastatic leiomyosarcoma of unknown origin. The PET/CT showed multiple ¹⁸F-FDG-avid subc...

Low grade lymphoma may transform into a more aggressive lymphoma and this transformation is usually associated with a poor outcome. A 65year old man presented with two metabolically active splenic lesions on a staging [18F] fluoro-2-deoxy-d-glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT). Histologic evaluation post spl...

A 63-year-old male was found to have a 7.5-cm splenic mass that had imaging appearances of an atypical haemangioma on CT, ultrasound and a 99mTc-RBC scan, and he was followed conservatively with serial ultrasounds. Sixteen months later, however, the splenic lesion grew and he developed numerous new liver masses which were biopsy confirmed to be a p...

Systemic radioisotope therapy with I-metaiodobenzylguanidine (I-MIBG) is an effective form of targeted therapy for neuroendocrine tumors. One of the absolute contraindications to administering I-MIBG therapy listed in the 2008 European Association of Nuclear Medicine guidelines is renal insufficiency requiring dialysis, although this contraindicati...

Systemic lupus erythematosus (SLE) is associated with a variety of inflammatory processes that can affect the lymph nodes, brain, kidneys, and spleen. We present two patients with SLE in whom SLE-associated conditions complicated interpretation of 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imagi...

A 67 year old woman with a 10 year history of rheumatoid arthritis (RA) treated with methotrexate and prednisone, presented with a 2 year history of worsening multiple cutaneous plaques of variable appearance. Two distinct skin lesions were biopsied to reveal a composite cutaneous lymphoma, possibly caused by long term methotrexate therapy. An [18F...

Follicular dendritic cell sarcoma (FDCS) is an extremely rare tumor with only 67 cases of head and neck FDCS reported in the literature. A 65-year-old female had a 6-cm follicular dendritic cell sarcoma resected from the left parotid gland with close margins. It recurred 1 year later as a 5-cm mass that was intensely [18F] fluoro-2-deoxy-D-glucose...

Disseminated histoplasmosis is an opportunistic infection encountered in immunocompromised patients such as those with human immunodeficiency virus infection/acquired immune deficiency syndrome. Involvement of the central nervous system (CNS) can occur in 5-20% of cases of disseminated histoplasmosis, and CNS histoplasmosis can be very difficult to...

Fibrous dysplasia accounts for approximately 7% of benign bone tumours and is a developmental disorder of unknown aetiology. Malignant transformation has been reported in 0.4% of all cases of fibrous dysplasia, and the use of 18F-fludeoxyglucose positron emission tomography/CT scan in the evaluation of malignant transformation has not yet been esta...

Lymphomatoid granulomatosis is a rare Epstein-Barr virus-related lymphoproliferative disorder. We describe a case of a 42-year-old female with lupus nephritis and immunosuppression post renal transplant, who was diagnosed with central nervous system and lung lymphomatoid granulomatosis, as well as an Epstein-Barr virus-positive oesophageal ulcer, a...

Expander-based breast reconstruction is a popular form of post-mastectomy reconstruction and involves the temporary subcutaneous implantation of breast tissue expanders that require periodic, incremental inflation with sterile saline by injection until the desired amount of tissue is developed. One type of tissue expander injection port system curr...

Intra-abdominal desmoplastic small round cell tumours are rare aggressive tumours of mesothelial origin with less than 60 cases reported in the literature. They are difficult to treat and the role of 18F-fludeoxyglucose positron emission tomography (PET)/CT scan in their management has not been established. A 41-year-old male presented with a 21-cm...

A 49-year-old woman with known Klippel-Feil syndrome had a CT scan for staging of stage IIIA invasive carcinoma of the left breast. She was found to have cervicothoracic spinal dysraphism with diastematomyelia. An 18F-NaF bone PET done as part of the metastatic workup showed the characteristic sagittal bone spur, and MRI demonstrated a complete spl...

A 70-year-old woman presented with frequent episodes of hypoglycemia. Imaging revealed a 6-cm pancreatic mass with several liver lesions. The pancreatic mass was resected and confirmed to be a well-differentiated insulinoma. Surgery improved but did not resolve her hypoglycemic episodes, and she was referred for peptide receptor radionuclide therap...

Neuroendocrine tumors have a propensity to metastasize to the orbit, although the reason is unknown. A review of 251 neuroendocrine tumors treated with Lu-DOTATATE or I-MIBG at our institution since 2003 revealed 4 patients with orbital metastases (1.6%), 2 treated with Lu-DOTATATE and 2 with I-MIBG. Of these 4 patients, 1 patient was symptomatic w...

A 26-year-old woman with a 5-year history of metastatic paraganglioma due to hereditary paraganglioma-pheochromocytoma syndrome with SDHB mutation, who had failed multiple treatment regimens and had transfusion dependent pancytopenia, presented with progressive liver and bone metastases. She was unable to sleep due to painful skull metastases and h...

A 22-year-old woman with rapidly progressing metastatic paraganglioma due to hereditary paraganglioma-pheochromocytoma syndrome from an SDHB mutation, who recurred after neoadjuvant chemotherapy, was found to be MIBG avid. She was treated with 2 I-MIBG treatments and concurrent sunitinib, achieving a complete response. She was in full remission for...

A 52-year-old woman diagnosed with invasive ductal carcinoma of both breasts had a chest x-ray for preoperative assessment. A striking artifact was noted by the x-ray technologist, who, as a result, became very concerned about radiation exposure from the patient. The patient had undergone bilateral sentinel lymph node injections in the nuclear medi...

A 62-year-old man was diagnosed with a moderately differentiated gastric adenocarcinoma in the proximal stomach. A staging F-FDG PET/CT showed an intensely FDG-avid gastric mass, as well as a mildly FDG-avid misty nodular mesentery. After 3 cycles of neoadjuvant chemotherapy, a follow-up PET/CT showed partial response of the gastric primary, with i...

Neuroendocrine tumors have a propensity to metastasize to the heart, although the reason for this remains unknown. A review of 251 neuroendocrine tumor patients treated with 177Lu DOTATATE peptide receptor radionuclide therapy or 131I-MIBG therapy at our institution since 2003 revealed 2 patients with cardiac metastases (incidence, 0.8%), one treat...

A 54-year-old woman presented with a history of nausea, vomiting, diarrhea, and recurrent episodes of severe hypokalemia requiring hospitalization. Imaging revealed a pancreatic mass with liver metastases, histologically confirmed to be a neuroendocrine tumor. Elevated active renin and aldosterone levels were identified, and the patient was treated...

A 57-year-old woman diagnosed with ectopic Cushing syndrome was found to have a In-octreotide-avid corticotropin-producing pancreatic neuroendocrine tumor with liver metastases. She was treated with 4 induction and 4 maintenance cycles of Lu-DOTATATE, which normalized her serum corticotropin levels and dramatically reduced the size of the pancreati...

A high percentage of paragangliomas express somatostatin receptors that can be utilized for targeted radioisotope therapy. The aim of this study was to describe and discuss the challenges of treating these tumors with (177)Lu-[DOTA(0),Tyr(3)]octreotate (DOTATATE) radioisotope therapy using established protocols. Three paraganglioma patients were tr...

A 70-year-old woman presented with frequent episodes of hypoglycemia. Imaging revealed a 6-cm pancreatic mass with several liver lesions. The pancreatic mass was resected and confirmed to be a well-differentiated insulinoma. Surgery improved but did not resolve her hypoglycemic episodes, and she was referred for peptide receptor radionuclide therap...

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a rare, recently described vascular neoplasm that occurs predominantly in the distal extremities of young to middle aged adult males. In this report, we describe a patient who presented with numerous lytic bone lesions which were intensely F-FDG avid on PET/CT and presumed to be meta...

The aim of this study was to evaluate the frequency and clinical significance of incidental focal uptake of (18)F-fluorodeoxyglucose (FDG) on positron emission tomography/computed tomography (PET/CT) in the parotid glands of cancer patients. A retrospective review of 7,252 oncologic PET/CT studies was done. FDG positive parotid incidentalomas occur...

A 51-year-old man with a recurrent metastatic esthesioneuroblastoma (olfactory neuroblastoma) was referred for peptide receptor radionuclide therapy (PRRT). He received 4 treatments of In-111-octreotide over 8 months and 3 treatments of Lu-177-DOTATATE over 4 months, which helped alleviate his symptoms and improved his quality of life; however, the...

A 47-year-old man presented with a recurrent thymoma World Health Organization type A of the anterior chest wall with pleural metastases after failing chemotherapy. The tumor was positive on In-octreotide, and he was referred for peptide receptor radionuclide therapy (PRRT) with Lu DOTATATE. He received 4 induction and 2 maintenance Lu DOTATATE tre...

Active surveillance (AS) is an increasingly popular management strategy for men diagnosed with low-risk indolent prostate cancer. Current tests (prostate-specific antigen [PSA], clinical staging, and prostate biopsies) to monitor indolent disease lack accuracy. (11)C-choline positron emission tomography (PET) has excellent detection rates in local...

A 51-year-old man with a recurrent metastatic esthesioneuroblastoma (olfactory neuroblastoma) was referred for peptide receptor radionuclide therapy (PRRT). He received 4 treatments of In-octreotide over 8 months and 3 treatments of Lu-DOTATATE over 4 months, which helped alleviate his symptoms and improved his quality of life; however, the tumor u...

Two patients diagnosed with metastatic medullary thyroid carcinoma (MTC) were referred for peptide receptor radionuclide therapy (PRRT) with Lu-[DOTA,Tyr]octreotate (DOTATATE). Each patient was treated with 4 doses of Lu-DOTATATE given 2 months apart. One patient achieved stable disease for 10 months then chose to pursue surgery, and the other achi...

A 61-year-old woman diagnosed with a metastatic well-differentiated neuroendocrine tumor of the cecum was referred for radioisotope therapy. Although her metastatic neuroendocrine tumor was positive on both I-MIBG and In-octreotide, there was a left parotid mass that was octreotide avid but MIBG negative. Further investigation also showed discordan...

An 18-year-old girl presented with a 3-year history of a recurrent skull base mass confirmed to be a rhabdoid papillary meningioma. The tumor was octreotide avid and metastatic to the lungs, thoracic lymph nodes, and bones, and she was referred for PRRT (peptide receptor radionuclide therapy) with Lu DOTATATE. After 3 induction treatment cycles of...

A 64-year-old woman with a 30-year history of recurrent sellar masses presented with severe headache and rapidly progressive visual field loss in the left eye. She was diagnosed with an extraventricular neurocytoma, which was octreotide positive, and was referred for PRRT (peptide receptor radionuclide therapy) with Lu [DOTA,Tyr]octreotate (DOTATAT...

A 39-year-old man diagnosed with a small bowel neuroendocrine tumor metastatic to the liver, lymph nodes, and bones achieved stable disease with I-MIBG therapy totalling 17 treatments over 9 years (cumulative dose of 1.9 Ci). His disease progressed after the 17th I-MIBG treatment, and he went on to fail chemotherapy, developing severe ascites requi...

A 60-year-old woman diagnosed with a well-differentiated neuroendocrine tumor metastatic to the liver and lymph nodes was treated with 4 induction cycles and 2 maintenance cycles of Lu [DOTA,Tyr]octreotate (DOTATATE) peptide receptor radionuclide therapy. Her posttreatment imaging showed partial response after 4 induction cycles and complete respon...

A 73-year-old man diagnosed with small bowel neuroendocrine tumor (NET) with liver and bone metastases was treated with 4 induction cycles and 2 maintenance cycles of Lu-DOTATATE peptide receptor radionuclide therapy (PRRT). His symptoms and mobility improved significantly following induction as well as maintenance treatments, and posttherapy imagi...

Aims: Increased 18 F-fluorodeoxyglucose uptake within active brown adipose tissue (BAT) on an 18 F-fluorodeoxyglucose PET/CT study is a known pitfall that has been well described in the literature. We have noted a similar phenomenon occurring in gallium-67 studies performed on neonates, which introduces an undesirable element of complexity when eva...

The aim of this study was to examine whether positron emission tomography (PET)/computed tomography (CT) can detect more cases of colorectal cancer (CRC) than serum carcinoembryonic antigen (CEA), both at initial staging and during surveillance for recurrence. A retrospective review of 639 CRC patients imaged with PET/CT was performed. PET/CT was s...

Objective: The purpose of this study was to determine if there is an association between necrosis as identified on staging (18)F-FDG PET/CT and overall survival (OS) and progression-free survival (PFS) in patients with sarcoma. Materials and methods: Sixty-six patients with newly diagnosed limb and girdle sarcoma underwent PET/CT at our institut...

Gastric neuroendocrine carcinomas (NEC) are very rare, aggressive tumors of the stomach that are distinct from the more benign neuroendocrine tumors, sometimes referred to as "gastric carcinoids." We present 3 cases of gastric NEC representing various histological subtypes that were successfully staged and followed with F-FDG PET/CT, impacting ther...

A 28-year-old woman with a history of prior bilateral retinoblastoma presented with general fatigue, anemia, and a urinary bladder mass seen on abdominal ultrasound and CT. She was referred for a staging F-FDG PET/CT, which showed an intensely FDG-avid bladder mass that was biopsied to reveal a leiomyosarcoma, with no evidence of metastases, which...

A wide variety of malignant renal and urinary bladder diseases can be detected on (18)F-FDG PET/CT. Although the PET/CT findings are often nonspecific, the aim of this atlas was to demonstrate that the spectrum of renal and urinary bladder malignancy that can be evaluated with PET/CT is much broader than current medical literature would suggest. PE...

The objective of our study was to determine whether there is a statistically significant correlation between metabolic activity of osseous and soft-tissue sarcomas as measured by the maximum standardized uptake value (SUV(max)) on (18)F-FDG PET/CT and histopathologic characteristics such as mitotic counts, the presence of necrosis, and the presence...

A 59-year-old man with a 30-year history of multiple recurrences of a giant cell tumor (GCT) of the left knee was referred for an 18F-FDG PET/CT to evaluate a solitary pulmonary nodule. The nodule was mildly FDG-avid, raising suspicion of malignancy. It was excised and histologically proven to be a GCT pulmonary metastasis. A follow-up PET/CT done...

Tetrasomy 8 is a relatively rare chromosomal abnormality that has been reported in only 33 cases in hematologic disorders. It is known for its association with aggressive acute myeloid leukemia (AML) and myeloid sarcoma and is considered a very poor prognostic factor. Myeloid sarcoma is a rare hematologic malignancy characterized by tumor masses co...

Sarcomatoid carcinomas of the lung account for less than 0.4% of all lung tumors, and they are a heterogeneous group of non-small-cell lung carcinomas containing a sarcoma or sarcoma-like component. They have a poor prognosis, with an overall 5-year survival of 25% compared with 45% for other types of non-small-cell lung carcinomas. The literature...

A 73-year-old man suffering from Cowden syndrome with gastrointestinal polyposis was referred for an F-FDG PET/CT after a routine gastroscopic biopsy revealed a poorly differentiated adenocarcinoma. The F-FDG PET/CT identified 2 foci of FDG-avid gastric adenocarcinoma on the background of extensive gastric and colorectal polyposis, and correctly st...

Objective: The purpose of this article is to illustrate a wide spectrum of malignant primary and secondary pleural and pericardial diseases imaged with (18)F-FDG PET/CT. Conclusion: A wide variety of malignant pleural and pericardial diseases can be detected, staged, and monitored by FDG PET/CT. Although the PET/CT findings are often nonspecific...

A 67-year-old woman, who presented with a 2 month history of dyspnea, had a ventilation and perfusion lung scan that showed absent perfusion of the entire right lung with normal ventilation, as well as a rounded matched defect in the left lower lung adjacent to midline, suspicious for an aortic aneurysm or dissection. CT pulmonary angiography revea...

A 58-year-old female who presented with a lower gastrointestinal bleed was referred for an (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT after a colonoscopy revealed a submucosal mass in the ascending colon. The PET/CT confirmed the presence of an FDG-avid mass in the ascending colon with no other FDG-avid abnormalities. Dual...

A 53-year-old male with a remote history of colon adenocarcinoma presented with weakness, severe anaemia and an actively bleeding ulcerated lesion in the stomach. An 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed FDG-avid masses in the stomach and mesentery, which were biopsied to reveal an unsuspected diagnosis of plasma...

A 66-year-old man, who presented with bright red blood per rectum, was referred for an 18 F-FDG PET/CT after colonoscopy showed two suspicious colon masses, which were biopsied to reveal an adenocarcinoma of unknown origin. PET/CT showed two intensely FDG-avid colon masses as well as an unsuspected FDG-avid lung mass, which was biopsied to reveal a...

Bilateral renal masses are uncommon but can raise a strong suspicion of primary or secondary malignan-cy, especially during the initial work-up of an oncology patient. Renal oncocytomas are benign renal tumors that are commonly discovered incidentally on diagnostic imaging with a small percentage occurring bilaterally. Although 18 F-FDG uptake in r...

A 34-year-old man, who presented with a 10-month history of an enlarging right ankle mass histologically proven to be a round cell/myxoid liposarcoma, was referred for an F-18 FDG PET/CT scan, which showed a heterogenous FDG-positive primary in the ankle and a 1.2-cm, FDG-negative, retroperitoneal lipid-attenuating nodule. On a follow-up PET/CT sca...

Incidental head and neck abnormalities are increasingly detected with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Incidental thyroid lesions on PET are described in many studies; however, no reports have definitively identified incidental findings in multiple head and neck sites. The aim of this study was to (1) review the relate...

Progressive transformation of germinal centers (PTGC) is a benign reactive adenopathy that leads to abnormal nodal enlargement. Although not believed to be premalignant, recent genetic studies have found evidence linking PTGC to Hodgkin lymphoma. In this case of a 14-year-old girl referred for an F-18 FDG PET/CT, extensive FDG-avid lymphadenopathy...

Plasmablastic lymphoma of the oral cavity is a very rare and only recently recognized entity that has been identified almost exclusively in HIV-infected individuals. It has a predilection for the oral cavity, often exhibits very aggressive behavior and has a poor prognosis. The use of 18F-FDG PET/CT in the evaluation of HIV-associated lymphomas is...

A 20-year-old woman, who presented with a several-week history of abdominal pain, was referred for magnetic resonance imaging (MRI) and 18 F-fluorodeoxy-glucose (FDG) positron emission tomography (PET)/com-puted tomography (CT) after an ultrasound showed complex cystic masses arising from both ovaries. The MRI and 18 F-FDG PET/CT imaging characteri...

Mycobacterium simiae (M. simiae) is an opportunistic pathogen rarely associated with human disease, although in recent years M. simiae has been detected with increasing frequency in human immunodeficiency virus (HIV)-infected patients, usually causing disseminated infection with fever, diarrhea and weight loss. We report the case of an HIV-positive...

About one-third of patients with Crohn disease develop intra-abdominal fistulas, and of these, cholecystocolic fistulas are among the rarest. F-18 FDG PET/CT can detect a vast variety of fistulas, although most are discovered incidentally. We present a very unusual case of a 79-year-old woman referred for an F-18 FDG PET/CT for evaluation of a soli...

A 66-year-old woman with long-standing multiple sclerosis presented with a several month history of diarrhea and weight loss. F-18 FDG PET/CT imaging revealed breast, rectal, and urinary bladder masses which were biopsied to reveal 3 different synchronous primary malignancies. PET/CT is able to detect a variety of synchronous malignancies; however,...

A 26-year-old man with a prior history of acute leukemia that was treated with a stem cell transplant (SCT) was referred for an F-18 FDG PET/CT to assess suspicious new gastric mucosal lesions. The lesions were FDG-avid and were histologically proven to be acute lymphoblastic leukemia (ALL). Extramedullary relapse of ALL after SCT is very rare, wit...

Xerostomia is a significant morbidity of radiation treatment in the management of head and neck cancers. To preserve salivary function, a surgical technique has been developed that involves the transfer of one submandibular gland to the ipsilateral submental space, where it can be shielded during radiation therapy. F-18 FDG PET/CT imaging character...

We present a case of a woman with ulcerative colitis who was referred for an F-18 FDG PET/CT after a suspicious colonoscopy and biopsy. PET/CT showed multiple elongated foci of intense FDG uptake in the colon, a pattern commonly reported with inflammatory bowel disease; however, the possibility of lymphoma was raised. Reevaluation of the biopsies w...

A 30-year-old woman was referred for an F-18 fluorodeoxyglucose (FDG) PET/CT to rule out lymphoma, and was found to have an incidental FDG-avid right breast nodule that grew significantly in size and FDG uptake on a subsequent scan, raising suspicion of a growing breast malignancy. Histologic evaluation showed a complex fibroadenoma with adenosis a...

A 36-year-old woman presented with a 5-month history of a growing left thigh mass, causing difficulty walking. Biopsy revealed a malignant epithelioid hemangioendothelioma (EHE), and the patient was referred for a staging F-18 FDG PET/CT that showed intense FDG uptake in the thigh mass, but no FDG-avid local lymph nodes or distant metastases. A few...

Malignant extrarenal rhabdoid tumor (ERRT) is a very rare type of soft-tissue sarcoma with a reported incidence of 0.3% of all soft-tissue sarcomas. Only 7 cases of spinal malignant ERRT have been reported in the literature, and to our knowledge, F-18 FDG PET/CT imaging for staging and evaluation of response to therapy for these tumors has not been...

Chondromyxoid fibroma (CMF) is a rare benign bone tumor of chondroid origin that occurs mostly in the metaphyses of long bones. CMF can occasionally mimic a chondrosarcoma on CT, and the literature on the 18F-FDG PET/CT imaging characteristics of CMF tumors is limited. In the presented case, a large histologically proven CMF chest wall mass was ini...

This report of an 82-year-old man who presented with a 3-week history of an enlarging left axillary mass and mild fevers, highlights the usefulness of both gallium-67 and F-18 FDG PET/CT imaging in the staging of histiocytic sarcoma. While PET/CT was superior in determining the extent of the disease, gallium can be used to help stage the disease in...

Diaphragmatic hernias are characterized by defects in the diaphragm that allow herniation of abdominal contents into the thorax. Herniation through the retrosternal foramen of Morgagni is rare, with less than 300 adult cases reported in the literature. This is a case of a 90-year-old woman who was diagnosed with herniation of the liver through the...

Angiomatoid fibrous histiocytoma is a very rare tumor that accounts for 0.3% of all soft-tissue tumors, and occurs predominantly in the extremities of adolescents and young adults. It has been classified by the World Health Organization as a tumor of uncertain differentiation with intermediate malignant potential, although recent evidence suggests...

This is a case of a 52-year-old woman who underwent a hysterectomy to treat a large uterine perivascular epithelioid cell tumor. She was followed with serial F-18 FDG PET/CT scans due to positive surgical margins and vascular invasion on pathology. Initial surveillance PET/CT performed 6 months post surgery was negative; however, a second surveilla...

A 69-year-old woman who presented with left lower quadrant abdominal pain and elevated serum cancer antigen 125 (CA-125) levels was referred for an MRI and an (18)F-FDG PET/CT to evaluate a suspicious abdominal mass seen on ultrasound. PET/CT showed extensive, intensely FDG-avid, omental and pelvic peritoneal thickening with no suspicious ovarian o...

A previously healthy 27-year-old woman presented with a thyroid goiter, symptoms of thyrotoxicosis, and mild respiratory obstruction. The serum thyroid stimulating hormone (TSH) was suppressed, serum T4 was elevated, and 24-hour radioiodine uptake was elevated at 59%. Thyroid scintigraphy showed intense uptake in an enlarged gland, with a cold nodu...

Necrotic pseudotumor is a complication of metal-on-metal arthroplasty that has been reported with increasing frequency in the last 5 years. It is believed to be the result of a hypersensitivity reaction to metal ions such as nickel, cobalt, or chromium that are released in large quantities from these prostheses. The imaging appearance of a necrotic...

A 77-year-old woman presented with sudden onset of loss of vision in the left eye and bilateral eye inflammation. Biopsy of the vitreous fluid of the right eye revealed large abnormal cells suggestive of lymphoma. A staging F-18 FDG PET/CT showed intense uptake in the hypothalamus, and mild focal uptake in the subcutaneous tissues of the right lowe...

Dermatopathic lymphadenitis (also known as lipomelanotic reticulosis, or Pautrier-Woringer disease) is a rare type of benign lymphatic hyperplasia associated with a variety of exfoliative or eczematoid type inflammatory erythrodermas. The axillary and inguinal regions are most commonly affected, although occasionally it can present in the head and...

A 64-year-old man with high-grade follicular lymphoma had a staging F-18 FDG PET/CT scan, which showed extensive disease in the lymph nodes, skeleton, and spleen. After 5 cycles of chemotherapy, a post-therapy PET/CT showed resolution of all abnormal findings except for 1 lesion in the neck. Biopsy revealed a Hurthle cell thyroid carcinoma. This un...

Vascular grafts have an infection rate ranging from 1% to 3%. While early infections occur within 4 months after surgery and are associated with virulent organisms, late infections can occur after months to years of surgery and are often caused by low virulence organisms that survive in an adherent biofilm. Host defense recognition of bacterial bio...

Primary Effusion Lymphoma (PEL) is a rare form of Non-Hodgkin lymphoma that involves serous body cavities (pleural, pericardial, or peritoneal) with lymphomatous effusions in the absence of lymphadenopathy or organomegaly. Although it was seen mostly in HIV-positive patients, it has recently been reported in HIV-negative patients with chronic Hepat...

Post-transplant lymphoproliferative disorder (PTLD) occurs in 1.2% of pediatric renal transplant patients, and is frequently Epstein-Barr Virus mediated. Hodgkin Lymphoma PTLD is the rarest of the 4 types of PTLDs recognized by the World Health Organization, with an incidence of <4% of all PTLD patients. It has a distinct clinical course and treatm...