Intense 18-fluorodeoxyglucose uptake by the thymus on PET scan does not necessarily herald recurrence of thyroid carcinoma

J Endocrinol Invest. 2005 Dec;28(11):1024-8. doi: 10.1007/BF03345343.

Abstract

This is the first report of intense fluorodeoxyglucose positron emission tomography (FDG-PET) uptake secondary to thymic hyperplasia during follow-up for thyroid carcinoma. A 36-yr-old woman underwent thyroidectomy for a papillary carcinoma measuring 4 cm in diameter. After two doses of radioiodine, thyroglobulin (Tg) remained detectable following recombinant human TSH (rhTSH) stimulation. A whole body scan (WBS) was negative. On computed tomography (CT) scan, a slightly lobulated thymus was visualized. PET scan showed intense thymic uptake. Following resection, anatomo-pathological analysis showed homogenous hyperplastic thymic gland without neoplastic cells. Two months later, under levothyroxin (L-T4) substitution, Tg was no longer detectable and PET scanning did not show any 18-FDG uptake. This observation suggests that thymic FDG uptake does not necessarily herald recurrence of thyroid carcinoma and must be interpreted with caution in such a setting. Other conditions associated with abnormal uptake by hyperplastic thymus must also be envisaged.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carcinoma, Papillary / blood
  • Carcinoma, Papillary / diagnostic imaging*
  • Carcinoma, Papillary / surgery
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Iodine Radioisotopes
  • Neoplasm Recurrence, Local / pathology*
  • Radiopharmaceuticals*
  • Thymus Gland / diagnostic imaging*
  • Thyroglobulin / blood
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / diagnostic imaging*
  • Thyroid Neoplasms / surgery
  • Thyroidectomy
  • Thyrotropin / pharmacology
  • Thyroxine / pharmacology
  • Tomography, Emission-Computed

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Thyrotropin
  • Thyroglobulin
  • Thyroxine