Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic
Celiac disease is an immune-mediated disorder triggered by hypersensitivity to gluten occurring in genetically susceptible individuals. A high-index of suspicion is needed for diagnosis as patients can be asymptomatic or present with atypical symptoms or extra-intestinal manifestations. Typical 18F-...
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Mashhad University of Medical Sciences
2021-01-01
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| Series: | Asia Oceania Journal of Nuclear Medicine and Biology |
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| Online Access: | https://aojnmb.mums.ac.ir/article_16763_94cd9b431350fd07c2abb5555a1db4d8.pdf |
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| author | Ananya Panda Michael McCarthy Joseph Murray Rosalind Sharain Min Shi Ayse Kendi |
| author_facet | Ananya Panda Michael McCarthy Joseph Murray Rosalind Sharain Min Shi Ayse Kendi |
| author_sort | Ananya Panda |
| collection | DOAJ |
| description | Celiac disease is an immune-mediated disorder triggered by hypersensitivity to gluten occurring in genetically susceptible individuals. A high-index of suspicion is needed for diagnosis as patients can be asymptomatic or present with atypical symptoms or extra-intestinal manifestations. Typical 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) gastrointestinal manifestations of celiac disease include increased multifocal or diffuse jejunal and ileal uptake; focal duodenal uptake is less common. Splenomegaly with increased splenic FDG uptake is also uncommon in celiac disease in the absence of portal hypertension; small-sized spleen and functional hyposplenism are more typical. We report a case of celiac disease diagnosed after PET/CT showed FDG uptake in the duodenum and enlarged spleen. Follow-up after gluten-free diet showed complete metabolic resolution and regression of splenomegaly. The combination of focal bowel and splenic uptake is unusual in celiac disease and may be mistaken for a lymphoproliferative disorder. Awareness of this entity may avoid misdiagnosis and guide appropriate management. |
| first_indexed | 2024-12-16T10:07:31Z |
| format | Article |
| id | doaj.art-19a852d91777424d8725289dee9b8f91 |
| institution | Directory Open Access Journal |
| issn | 2322-5718 2322-5726 |
| language | English |
| last_indexed | 2024-12-16T10:07:31Z |
| publishDate | 2021-01-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Asia Oceania Journal of Nuclear Medicine and Biology |
| spelling | doaj.art-19a852d91777424d8725289dee9b8f912022-12-21T22:35:37ZengMashhad University of Medical SciencesAsia Oceania Journal of Nuclear Medicine and Biology2322-57182322-57262021-01-0191515510.22038/aojnmb.2020.49000.133316763Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma MimicAnanya Panda0Michael McCarthy1Joseph Murray2Rosalind Sharain3Min Shi4Ayse Kendi5Departments of Radiology, Mayo Clinic, Rochester, Minnesota, USADepartments of Pathology, Mayo Clinic, Rochester, Minnesota, USADepartments of Gastroenterology, Mayo Clinic, Rochester, Minnesota, USADepartments of Pathology, Mayo Clinic, Rochester, Minnesota, USADepartments of Pathology, Mayo Clinic, Rochester, Minnesota, USADepartments of Radiology, Mayo Clinic, Rochester, Minnesota, USACeliac disease is an immune-mediated disorder triggered by hypersensitivity to gluten occurring in genetically susceptible individuals. A high-index of suspicion is needed for diagnosis as patients can be asymptomatic or present with atypical symptoms or extra-intestinal manifestations. Typical 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) gastrointestinal manifestations of celiac disease include increased multifocal or diffuse jejunal and ileal uptake; focal duodenal uptake is less common. Splenomegaly with increased splenic FDG uptake is also uncommon in celiac disease in the absence of portal hypertension; small-sized spleen and functional hyposplenism are more typical. We report a case of celiac disease diagnosed after PET/CT showed FDG uptake in the duodenum and enlarged spleen. Follow-up after gluten-free diet showed complete metabolic resolution and regression of splenomegaly. The combination of focal bowel and splenic uptake is unusual in celiac disease and may be mistaken for a lymphoproliferative disorder. Awareness of this entity may avoid misdiagnosis and guide appropriate management.https://aojnmb.mums.ac.ir/article_16763_94cd9b431350fd07c2abb5555a1db4d8.pdfceliac diseasesplenomegaly18f-fdg pet/ctincidental bowel uptakelymphoma |
| spellingShingle | Ananya Panda Michael McCarthy Joseph Murray Rosalind Sharain Min Shi Ayse Kendi Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic Asia Oceania Journal of Nuclear Medicine and Biology celiac disease splenomegaly 18f-fdg pet/ct incidental bowel uptake lymphoma |
| title | Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic |
| title_full | Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic |
| title_fullStr | Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic |
| title_full_unstemmed | Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic |
| title_short | Incidentally Detected Celiac Disease with Splenomegaly on 18F FDG PET/CT: A Potential Lymphoma Mimic |
| title_sort | incidentally detected celiac disease with splenomegaly on 18f fdg pet ct a potential lymphoma mimic |
| topic | celiac disease splenomegaly 18f-fdg pet/ct incidental bowel uptake lymphoma |
| url | https://aojnmb.mums.ac.ir/article_16763_94cd9b431350fd07c2abb5555a1db4d8.pdf |
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