68Ga-DOTATATE Uptake in Pulmonary Lymphangitic Carcinomatosis: A Rare Form of Metastasis in Pediatric Neuroblastoma

A 6-year-old boy with refractory high-risk neuroblastoma underwent 68Ga-DOTATATE PET/CT to evaluate the therapy response. The initial scan revealed multiple metastatic lesions, including bone, lymph nodes, and lung involvement. After 2 cycles of combination therapy, follow-up 68Ga-DOTATATE PET/CT demonstrated an increase in both the number and extent of lesions compared with the baseline scan, indicating disease progression. Notably, abnormal 68Ga-DOTATATE uptake was observed in pulmonary lymphangitic carcinomatosis. This case underscores the diagnostic utility of 68Ga-DOTATATE PET/CT in identifying pulmonary lymphangitic carcinomatosis in pediatric neuroblastoma.