Vertebral photopenia on [⁶⁷Ga]Ga-citrate and [¹⁸F]FDG PET/CT imaging in a patient with non-Hodgkin lymphoma

A cold vertebral defect is an uncommon finding, especially in Gallium-67-citrate ([Ga-67]Ga-citrate) - and [F-18]fluorodeoxyglucose ([18F]FDG) - avid lymphomas, representing a diagnostic challenge. Here, we present the case of a patient with non-Hodgkin lymphoma (NHL), in whom the [Ga-67]Ga-citrate and [F-18]FDG scans showed a diffuse skeletal uptake pattern with concomitant appearance of a cold vertebral defect. Awareness of the different causes of such uptake patterns and accurate clinical information is important to avoid misinterpretation of nuclear studies in oncologic patients.