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Related Experiment Videos

22. FDG Uptake in Infectious Mononucleosis.

Tomas1, Tronco, Karayalcin

  • 1Long Island Jewish Medical Center, New Hyde Park, NY, USA

Clinical Positron Imaging : Official Journal of the Institute for Clinical P.E.T
|January 11, 2001
PubMed
Summary

Positron emission tomography-FDG imaging can mimic lymphoma in adolescents with infectious mononucleosis. Early clinical, hematologic, and serologic assessments are crucial before imaging to avoid misdiagnosis.

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Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Positron emission tomography-FDG (fluorodeoxyglucose) imaging is increasingly used for lymphoma staging and treatment response monitoring in children.
  • An adolescent case presented with symptoms and imaging findings mimicking lymphoma, but was diagnosed with infectious mononucleosis.

Purpose of the Study:

  • To highlight a case where infectious mononucleosis mimicked lymphoma on FDG-PET imaging.
  • To emphasize the importance of comprehensive clinical evaluation before FDG-PET imaging.

Main Methods:

  • A 13-year-old male with a neck mass, fatigue, fever, and weight loss was evaluated for lymphoma.
  • Diagnostic workup included complete blood count, erythrocyte sedimentation rate, serologic tests (EBV, CMV, toxoplasmosis, hepatitis), chest X-ray, CT scan, and FDG-PET imaging.

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  • Final diagnosis was confirmed by positive Monospot and EBV panel results.

    • Main Results:

    • CT scan revealed enlarged cervical lymph nodes with necrosis and massive splenomegaly.
    • FDG-PET imaging demonstrated intense uptake in cervical regions, mediastinum, and spleen, consistent with lymphoma.
    • Serologic tests confirmed infectious mononucleosis.

    Conclusions:

    • Infectious mononucleosis can present with clinical and imaging findings similar to lymphoma in adolescents.
    • FDG-PET imaging, while sensitive, should be interpreted in conjunction with clinical, hematologic, and serologic data.
    • Accurate diagnosis requires a holistic approach, integrating all available diagnostic information.