False-positive finding of retropharyngeal lymph node recurrence in both fluorine (18)FDG PET and MRI in a patient with nasopharyngeal carcinoma

Head Neck. 2016 Apr;38(4):E84-6. doi: 10.1002/hed.24205. Epub 2015 Aug 28.

Abstract

Background: Biopsy of the retropharyngeal node is not routinely accessible. The diagnosis of retropharyngeal lymph node recurrence in patients with nasopharyngeal carcinoma (NPC) is often based on an imaging study.

Methods: We reported a patient with NPC who was incorrectly diagnosed with left retropharyngeal lymph node recurrence by both MRI and positron emission tomography (PET)/CT.

Results: A woman who was treated for stage IVA NPC 2 years previously was found to have a nodal lesion in the left retropharyngeal space on MRI together with focal fluorodeoxyglucose (FDG) uptake on PET/CT. Locoregional recurrence was suspected, and surgery was performed. Subsequent pathology results showed reactive lymphoid hyperplasia.

Conclusion: Although tissue biopsy for the retropharyngeal node is technically difficult, this case demonstrates that tumor recurrence cannot be diagnosed even based on both positive findings on MRI and PET/CT in patients with NPC.

Keywords: MRI; locoregional recurrence; nasopharyngeal carcinoma; positron emission tomography; retropharyngeal lymph node.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biopsy
  • Diagnostic Errors
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging / methods*
  • Nasopharyngeal Neoplasms / diagnostic imaging*
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Positron Emission Tomography Computed Tomography / methods*

Substances

  • Fluorodeoxyglucose F18