Comparative Imaging Analysis of Kimura’s Disease Using 18F-FDG PET/CT and [18F]AlF-NOTA-FAPI-04 PET/CT

Figures

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  Figure 1. (A) Enlargement of the right parotid gland (solid arrow); (B) Histopathological image (HE ×20) showing lymphoid proliferation within fibroadipose tissue of the right parotid gland mass, with dense infiltration of lymphocytes and eosinophils, formation of lymphoid follicles, presence of eosinophilic microabscesses, and capillary proliferation. MRI of the oropharynx shows on T1-weighted imaging (C) and T2-weighted imaging (D), an enlarged right parotid gland with patchy areas of high signal intensity on both sequences, measuring approximately 3.0×2.6 cm.

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  Figure 2. The scan identified a soft tissue nodule in the right parotid gland, measuring 1.8×1.1cm with increased tracer uptake (solid arrows; (A) whole-body MIP image; (B) axial fused PET/CT image; (C) coronal fused PET/CT image; SUVmax = 3.6). There was also eyelid thickening (1.1 cm) with significant uptake (dotted arrow; (D) axial fused PET/CT image; SUVmax = 2.8), consistent with Kimura’s disease infiltration. Additionally, multiple lymph nodes were detected in the neck and clavicular region, with the largest measuring 1.6 cm (SUVmax = 4.1), suggesting a chronic inflammatory process.

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  Figure 3. 18F-FDG PET/CT demonstrated a soft tissue nodule in the right parotid gland (2.0 × 2.7 cm; solid arrows; (A) whole-body MIP image; (B) axial fused PET/CT image; (C) coronal fused PET/CT image) showed increased 18F-FDG uptake (SUVmax = 4.5). Mild eyelid thickening (0.8 cm; dotted arrow, (D) demonstrated tracer uptake (SUVmax = 2.8), with enlarged lymph nodes in the right neck and clavicular region (SUVmax = 3.9). Tonsils showed nonspecific inflammatory uptake (SUVmax = 9.4), and scattered lymph nodes in the left paracarotid sheath, submental region, and right axilla exhibited mild uptake, indicative of chronic inflammation. [18F]AlF-NOTA-FAPI-04 PET/CT revealed a nodule in the right parotid gland (2.0 × 2.8 cm; solid arrows; (E) whole-body MIP image; (F) axial fused PET/CT image; (G) coronal fused PET/CT image; SUVmax = 7.8) and eyelid thickening (dotted arrow, H; SUVmax = 7.0), consistent with Kimura’s disease. Additional findings included a right preauricular nodule (SUVmax = 6.8) and nodules in the left pinna and posterior neck (SUVmax = 3.9). Enlarged lymph nodes in the right cervical root and clavicular region showed mild uptake (SUVmax = 2.7), considering as chronic…