Figure 1.

Axial PET (top right), fused PET/CT (middle right) and CT scan (bottom right) images at the submandibular region level, with an MIP image (on left), from a PET study of a 66-year-old man recently diagnosed to have squamous cell carcinoma of the oropharynx. Clinical and CT evaluation staged the patient as T2, N0, M0. The PET scan reveals the large primary lesion in the oropharynx to be intensely FDG avid (dotted arrow) with another left oral cavity lesion (dotted arrow) and a left submandibular nodal focus (arrows). The patient had no visible lesion in the left oral cavity at the time of initial examination but subsequently developed an ulcerative lesion in the left lingual sulcus. The submandibular nodal focus localized to an 8-mm node on the CT scan and was not considered enlarged per CT criteria. The patient also had a moderate right hilar focus (seen on the MIP image) and subsequently developed into a non-small cell lung cancer a year later