Incidentally detected celiac disease with splenomegaly on 18F FDG PET/CT: A potential lymphoma mimic

Ananya Panda, Michael R. McCarthy, Joseph A. Murray, Rosalind F. Sharain, Min Shi, Ayse Tuba Kendi

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)51-55
Number of pages5
JournalAsia Oceania Journal of Nuclear Medicine and Biology
Volume9
Issue number1
DOIs
StatePublished - 2021

Keywords

  • 18F-FDG PET/CT
  • Celiac disease
  • Incidental bowel uptake
  • Lymphoma
  • Splenomegaly

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology (miscellaneous)
  • Biophysics

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