Nuclear Medicine & Radiation Therapy

A Case Report of False Positive FDG- PET/CT Mediastinal Lymph Node in Oesophageal Adenocarcinoma Revealed to be an Anthracotic and Anthracosilicotic Spindle Cell Pseudotumor (AASCP)

Abstract

Haidar M, Bannoura S, Hallal A, Ghanem AA, Dergham MY, Barakat A, Jreige M and Shabb N

Anthracotic and anthracosilicotic spindle cell proliferation (AASCP) is a rare reactive proliferative entity of phagocytic histiocytes which can affect hilar and mediastinal lymph nodes. Fluorodeoxyglucose-positron emission tomography (FDG-PET) has been used for the clinical diagnosis and staging of oesophageal adenocarcinoma. We report the first case of AASCP exhibiting false positivity on FDG-PET imaging. A 76-year-old man with distal esophageal adenocarcinoma underwent PET/CT for staging revealing a positive mediastinal lymph node involvement. The patient underwent Endobronchial Ultrasound Fine Needle Aspiration Biopsy (EBUS-FNA) followed by an oesophagectomy with lymph node dissection. The histological diagnosis of the mediastinal lymphadenopathy was AASCP. In mediastinal lymph nodes of esophageal adenocarcinoma, AASCP could be a cause of false-positivity on FDG-PET imaging.