Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Hodgkin's Lymphoma: Diagnostic Challenge during COVID Vaccination

Sharjeel Usmani; Fatma Al-Ramadhan; Fareeda Al-Kandari; Najeeb Ahmed

doi:10.4103/ijnm.ijnm_31_21

Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Hodgkin's Lymphoma: Diagnostic Challenge during COVID Vaccination

Indian J Nucl Med. 2021 Jul-Sep;36(3):343-346. doi: 10.4103/ijnm.ijnm_31_21. Epub 2021 Sep 23.

Authors

Sharjeel Usmani¹, Fatma Al-Ramadhan², Fareeda Al-Kandari², Najeeb Ahmed³

Affiliations

¹ Department of Nuclear Medicine, Castle Hill Hospital, Cottingham, UK.
² Kuwait Cancer Control Center (KCCC), Cottingham, UK.
³ Jack Brignall PET/CT Centre, Castle Hill Hospital, Cottingham, UK.

Abstract

Benign metabolic uptake on fluorine-18 fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) is not uncommonly seen after immunization. We report a case of 30-year-old man with Hodgkin's lymphoma who underwent two cycles of chemotherapy. Interim ¹⁸F-FDG PET/computed tomography demonstrated complete metabolic response of prior hypermetabolic bilateral supraclavicular and mediastinal lymph nodes. Although multiple new normal-sized hypermetabolic left axillary and subpectoral lymph nodes are noted, relevant history revealed COVID vaccine 7 days prior scan with mild FDG uptake at the left deltoid muscle. These new findings at the left axilla are likely related to recent vaccination. ¹⁸F-FDG PET uptake in the lymph nodes is not so uncommon after immunization; relevant history is very important especially in the phase of massive immunization to avoid false interpretation.

Keywords: COVID-19; Fluorine-18 fluorodeoxyglucose positron emission tomography; vaccination.