Schwannoma Mimicking Axillary Lymph Node Metastasis: A Comprehensive Radiology Guide to PET-CT, Ultrasound, MRI, and CT Diagnosis
Schwannoma Mimicking Metastatic Lymphadenopathy: The Critical Imaging Clues Every Radiologist Must Know When a cancer patient undergoes PET-CT and an FDG-avid axillary mass is discovered, the immediate concern is usually metastatic lymph node involvement. In daily radiology practice, increased FDG uptake is often interpreted as evidence of malignancy. However, this assumption can occasionally lead clinicians down the wrong diagnostic path. A particularly educational case involved a 76-year-old man with a history of nasopharyngeal carcinoma who presented with dysphagia and severe pain. PET-CT revealed an FDG-avid axillary lesion with an SUVmax of approximately 4.5, strongly suggesting metastatic lymphadenopathy. Yet the final diagnosis was something entirely different: Schwannoma. This case highlights one of the most important lessons in modern medical imaging: FDG uptake does not equal cancer. Understanding the radiologic features of schwannoma across ultrasound, CT, MRI, and PET-CT is...