Revealing Hidden Nodal Disease: FDG PET/CT Driven Detection of Occult Lymph Node Involvement in Blastic Plasmacytoid Dendritic Cell Neoplasm.

Kundu, Nivedita; Krishna, Jagatti; Kumar, Rakesh; Jain, Surabhi; Mallick, Saumyaranjan · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, aggressive malignancy characterized by skin involvement and frequent systemic dissemination. We report a case of a 32-year-old man with multiple violaceous cutaneous nodules who underwent F-18 FDG PET/CT for staging. PET/CT demonstrated extensive metabolic activity in cutaneous sites and revealed previously unsuspected inguinal and cervical lymph-node involvement. Histopathology confirmed BPDCN. This case highlights the crucial role of FDG PET/CT in detecting subclinical nodal disease, delineating total disease burden, and improving staging accuracy in BPDCN, thereby supporting its value in guiding management and future response assessment.

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