Challenging Results on FDG PET/CT in a Patient with Uncontrolled Celiac Disease and small bowel adenocarcinoma

Celiac disease (CD) is a chronic immune-mediated enteropathy that is caused by both environmental (gluten) and genetic (human leukocyte antigen (HLA) and non-HLA genes) factors. Patients may be asymptomatic or exhibit atypical symptoms, necessitating a high index of suspicion for proper diagnosis.Th...

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Bibliographic Details
Published in:Asia oceania journal of nuclear medicine and biology 2022-06, Vol.10 (2), p.155-160
Main Authors: Mohamedkhair Ali, Al-Ibraheem, Akram, Saad Abdlkadir Ahmed, Jaber, Omar
Format: Article
Language:English
Subjects:
Abdomen
Adenocarcinoma
Biopsy
Cancer
Case Report
Case reports
Celiac disease
Colon
Computed tomography
Diarrhea
Ethics
fdg pet/ct
Gastroenterology
Gluten
Histocompatibility antigen HLA
Lymphoma
Malignancy
Medical imaging
Metabolism
Patients
Positron emission tomography
single short segmental bowel uptake
Small intestine
Vertebrae
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Summary:Celiac disease (CD) is a chronic immune-mediated enteropathy that is caused by both environmental (gluten) and genetic (human leukocyte antigen (HLA) and non-HLA genes) factors. Patients may be asymptomatic or exhibit atypical symptoms, necessitating a high index of suspicion for proper diagnosis.The evaluation of CD patients with 18F-FDG PET/CT imaging can be difficult, owing to the fact that this disease is inflammatory in nature. Typical 18F-FDG PET/CT gastrointestinal manifestations of celiac disease include increased multifocal or diffuse bowel uptake, whereas single short segmental uptake is rarely encountered; thus, awareness of this wide range of findings is important to guide physicians through proper management and outcome.We report a case of small intestine adenocarcinoma and known CD complaining of recent episodes of diarrhea and weight loss that had a suspicious small bowel wall thickening that corresponds to a short segmental hypermetabolic process on FDG PET/CT follow-up scan. The patient was then referred to the gastroenterology department and underwent a colonoscopy, a biopsy was taken that revealed CD and was negative for malignancy. Furthermore, 6 months later the abovementioned segmental FDG activity was completely resolved without any treatment received at the given time.
ISSN:2322-5718
2322-5726
DOI:10.22038/AOJNMB.2022.61853.1437