FDG PET/CT Findings of Nodular Sclerosis-Subtype Classic Hodgkin Lymphoma Presented as Mediastinal Nodal Lesions at Onset But as Predominant Osseous Disease at Relapse.

Nodular sclerosis-subtype classic Hodgkin lymphoma in general manifests as bulky mediastinal lymphadenopathy but very rarely involves bones. We report FDG PET/CT findings of a 19-year-old man with pathology-proven, nodular sclerosis-type classic Hodgkin lymphoma. His initial FDG PET/CT scan at the diagnosis showed only hypermetabolic lymphadenopathy in the mediastinum. However, the FDG PET/CT acquired when the disease recurred 20 months later showed predominant osseous disease without additional nodal lesions outside the mediastinum.