Background: This study investigated the prognostic value of axillary lymph node (ALN) heterogeneity texture features through ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in patients with locally advanced breast cancer (LABC). Methods: We retrospectively analyzed 158 LABC patients with FDG-avid, pathology-proven, metastatic ALN who underwent neoadjuvant chemotherapy (NAC) and curative surgery. Tumor and ALN texture parameters were extracted from pretreatment ¹⁸F-FDG PET/CT using Chang-Gung Image Texture Analysis software. The least absolute shrinkage and selection operator regression was performed to select the most significant predictive texture parameters. The predictive impact of texture parameters was evaluated for both progression-free survival and pathologic NAC response. Results: The median follow-up period of 36.8 months and progression of disease (PD) was observed in 36 patients. In the univariate analysis, ALN textures (minimum standardized uptake value (SUV) (p = 0.026), SUV skewness (p = 0.038), SUV bias-corrected Kurtosis (p = 0.034), total lesion glycolysis (p = 0.011)), tumor textures (low-intensity size zone emphasis (p = 0.045), minimum SUV (p = 0.047), and homogeneity (p = 0.041)) were significant texture predictors. On the Cox regression analysis, ALN SUV skewness was an independent texture predictor of PD (p = 0.016, hazard ratio 2.3, 95% confidence interval 1.16–4.58). Conclusions: ALN texture feature from pretreatment ¹⁸F-FDG PET/CT is useful for the prediction of LABC progression.

Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B cell lymphoma with plasmablastic features that commonly occurs in the oral cavity of human immunodeficiency virus (HIV)-positive patients. Here we present a case of PBL involving the uterus in a 54-year old HIV-negative female patient. The torso positron emission tomography (PET)/CT revealed intense ¹⁸F-fludeoxyglucose (¹⁸F-FDG) uptake in a bulky uterus with multiple sites of metastatic disease including peritoneal seeding.