Role of 18F-FDG PET/CT imaging in the strategic selection of the accessory spleen as a biopsy site for definitive lymphoma diagnosis in a 67-year-old man: A Case report

Abstract

The role of18F-FDG PET/CT in lymphoma staging and treatment response assessment is well established in the literature. Beyond these conventional applications, it can also serve as a powerful tool for guiding biopsy decisions in diagnostically challenging cases. We present the case of a 67-year-old man with suspected lymphoma, in whom initial diagnostic procedures—including bone marrow aspiration—failed to yield conclusive results. A multidisciplinary team utilized18F-FDG PET/CT to identify an accessory spleen exhibiting metabolic activity comparable to the primary spleen. Given its accessibility and diagnostic potential, the accessory spleen was surgically excised, leading to a definitive diagnosis of mantle cell lymphoma. This case underscores the strategic role of PET/CT in biopsy site selection, offering a safer and less invasive diagnostic alternative and reinforcing its crucial role in lymphoma management.