“Quasi-Symmetric” FDG Avidity of Bilateral Salivary Glands in Mikulicz Disease Yielding False-Positive Staging in Lung Cancer

• Published in: Clinical nuclear medicine Vol. 37; no. 11; pp. 1102 - 1104
• Main Authors: Lin, Li-Fan, Shen, Daniel HY, Tsai, Wen-Chiuan, Hou, Cheng-Han, Cheng, Cheng-Yi, Chen, Ching-Yuan
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-11-2012
• Subjects: Aged; False Positive Reactions; Fluorodeoxyglucose F18; Humans; Lung Neoplasms - complications; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Male; Mikulicz' Disease - complications; Mikulicz' Disease - diagnostic imaging; Mikulicz' Disease - pathology; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Salivary Glands - diagnostic imaging; Salivary Glands - pathology; Tomography, X-Ray Computed
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/RLU.0b013e31826c0c35

ABSTRACTA 77-year-old man with lung cancer underwent fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Cervical FDG uptake of variable intensity was detected corresponding to enlarged masses in the bilateral parotid and left submandibular regions. We suspected metastases from primary lung cancer or coexisting salivary gland neoplasms. Histopathological examination of the FDG-avid parotid mass revealed Mikulicz disease, an uncommon autoimmune disease involving the salivary glands. We present this case of Mikulicz disease with “quasi-symmetric” FDG avidity in the major salivary glands. We believe that salivary FDG uptake can lead to erroneous interpretation of tumor staging using PET.