Figure 3: 51-year-old male with diagnosis of a T3N2M0 cancer of the base of the tongue on the left side. Post contrast CT shows a necrotic lymph node metastasis 3 cm in size in the left cervical level II (Fig. 3a, black star). On coronal CT slices lymph node metastases in the left level II and III are visible (Fig. 3b, black star; Fig. 3d and 3f). PET demonstrates intensive FDG uptake by the lymph node metastases (Figure 3e and 3f). A lymph node of 1.5 cm in the right neck level II could not be assessed with CT (Fig. 3a and 3b, white arrow). This lymph node shows intensive FDG Uptake in PET (Fig. 3e and 3f) and the fused axial and coronary PET-CT images (Fig. 3c and 3d). Bicervical neck dissection was performed. Histologically a lymph node metastasis was confirmed.
Intensive contrast agent accumulation in the primary tumor in the left sided base of the tongue (Fig. 3a, 2 white arrows) which correlates with intensive FDG uptake in PET-CT (Fig. 3c and 3e).