PMC5356393_01
(a) A diffuse extraoral swelling in the lower one-third of face extending to submandibular region and (b) lateral view of the swelling.
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F1
Patient consent was obtained for taking photograph and using it for study and publication purposes [Figure 1a and b].
(a) Panoramic radiograph showing generalized bone loss, (b) posterior-anterior chest radiograph, showing a normal study, (c) computed tomography of neck with contrast, axial section demonstrating enlarged lymph nodes without any enhancement or necrosis, (d) computed tomography, coronal section demonstrating enlarged lymph node pushing the submandibular gland to one side, (e) computed tomography of neck with contrast, sagittal section demonstrating lymph node enlargement at level Ib, II, III and V.
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F2
Panoramic radiograph revealed generalized horizontal bone loss and endodontically treated 36 with crown and periapical bone density [Figure 2a]. Posterior-anterior chest radiograph was noncontributory [Figure 2b]. Largest node measured 3.5 cm x 4.4 cm [Figure 2c]. However, the gland appeared normal and was separated from the nodal mass [Figure 2d]. The right side also showed level Ib, II, and V nodes, but they were discrete and showed no evidence of necrosis or any other mass lesion [Figure 2e].
(a) Positron emission tomography/computed tomography images showing fluoro-2-deoxyD-glucose avid supra and infra diaphragmatic lymph nodes and focal fluoro-2-deoxyD-glucose avid in spleen and (b) positron emission tomography/computed tomography images after chemotherapy showing complete metabolic and near complete anatomical resolution of supra/infra diaphragmatic lymph nodes and splenic deposits.
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F3
FDG avid supra and infra-diaphragmatic lymph nodal lesions indicating metabolically active NHL. Focal FDG avid within spleen were present [Figure 3a]. Whole-body PET/CT was done after six cycles of chemotherapy to assess the response to treatment, which showed complete metabolic and near complete anatomical resolution of supra/infra-diaphragmatic lymph nodes and splenic deposits [Figure 3b].