Complementary roles of 18F-FDG and 68Ga-pentixafor PET/CT in gastric MALT lymphoma
Abstract
Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade indolent B-cell non-Hodgkin lymphoma, for which conventional 18F-FDG PET/CT has limited sensitivity in detecting lesions with low proliferative activity. This report describes a 58-year-old male who presented with upper abdominal tenderness and pain, with no gastrointestinal bleeding or weight loss, and a negative Helicobacter pylori test. Contrast-enhanced CT detected gastric wall thickening at the gastric greater curvature, and endoscopic biopsy combined with immunohistochemistry confirmed gastric MALT lymphoma with a low Ki-67 proliferation index of 10%.18F-FDG PET/CT revealed mildly increased metabolism. Dual-modality imaging using 18F-FDG and 68Ga-pentixafor precisely delineated the lesion, assessed lymph node involvement, and determined the clinical stage, providing critical information for clinical treatment decisions. This typical case offers great teaching implications for nuclear medicine physicians by highlighting the diagnostic pitfall of weak FDG uptake in low-proliferative gastric MALT lymphoma and demonstrating the incremental value of dual-tracer imaging for standardized staging.
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Gastric MALT lymphoma, 18F-FDG, 68Ga-pentixafor
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