Unusually intense FDG uptake in a hypertrophied adenoid

The adenoids, or pharyngeal tonsils, are located in the posterior aspect of the midline of the roof of the nasopharynx. The lingual (floor), pharyngeal (roof), and palatine (lateral) tonsils compose the bulk of the lymphoid tissue of Waldeyer's ring. They play important roles in host defense against locally invading pathogens and induction of secretory immunity for upper respiratory tract infections. Intense uptake of 18-fluoro-2-deoxyglucose (FDG) in the adenoids is seldom found in adults. A 34-year-old woman who had chronic sinusitis and acute rhinitis at presentation underwent an FDG-positron emission tomographic (PET) study for a whole-body cancer screening. The PET images revealed focally intense uptake of FDG in the adenoids. A coregistered CT scan also revealed a soft tissue lesion in the corresponding region and vegetation of the adenoids were identified by an ear, nose and throat doctor. After symptomatic treatment and follow up for over 1 year, no malignancy was detected.