Prostate-Specific Membrane Antigen PET Positivity in a Lung Mass

Abstract

An 84-year-old man with nonmetastatic castrate-sensitive prostate cancer was referred for a 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT scan with a prostate-specific antigen level of 3.6 ng/mL for restaging. He was 22 years post-radical prostatectomy and had salvage radiation being managed with intermittent hormonal therapy. Imaging revealed a right lower lobe mass with increased PSMA uptake (SUV max 6.2). Biopsy and subsequent immunostaining determined the mass to be diffuse large B-cell lymphoma. We report a case of diffuse large B-cell lymphoma diagnosed in the setting of PSMA positivity, highlighting awareness for oncologists and radiologists to know this possibility.

Increased PSMA-Targeted 18F-DCFPyL Uptake in Peripheral T-Cell Lymphoma

“…PSMAtargeted PET/CT is a novel imaging modality with higher sensitivity and greater specificity for detection of prostate cancer than conventional imaging, such as bone scintigraphy or CT. 2,3 In addition to prostate cancer, increased 18 F-DCFPyL uptake has been reported in cancers including diffuse large B-cell lymphoma and follicular lymphoma, and nonmalignant conditions including sarcoidosis. [4][5][6] The current case demonstrated anaplastic large cell lymphoma, a PTCL, also has active uptake of 18 F-DCFPyL. We report on the imaging findings of a patient with a history of prostate cancer ultimately diagnosed with PTCL, and the preceding findings from 18 F-DCFPyL PET/CT.…”

Unusual Presentation of Solitary Penile Metastasis of Prostate Cancer on 68Ga-PSMA PET/CT

“…This case highlights the critical assessment of an isolated focal penile activity that should not be misinterpreted as contamination from radioactive urine 1 . In the literature, most of the cases with penile metastases originating from genitourinary cancers were primarily treated with brachytherapy or external beam radiation of curative intent 1–3 . Few case reports presented penile metastasis postradical prostatectomy, which are however often associated with more disseminated systemic disease 4–7 .…”

“…In the setting of oligometastases, the lesion was surgically resected, and histopathology proved its metastatic nature. This case highlights the critical assessment of an isolated focal penile activity that should not be misinterpreted as contamination from radioactive urine 1 . In the literature, most of the cases with penile metastases originating from genitourinary cancers were primarily treated with brachytherapy or external beam radiation of curative intent 1–3 .…”

Solitary Prostate Carcinoma Penile Metastasis on 18F-DCFPyL PET/CT

“…In conclusion, metastatic prostatic cancer can manifest with a range of clinical presentations, and it is important to consider the possibility of metastatic disease to uncommon sites such as the penis. PSMA PET/CT imaging is capable of detecting these rare sites of metastases, 9,10 making it a valuable diagnostic tool for assessing the extent of disease in prostate cancer patients.…”