18F-FDG PET/CT Scan Can Predate Clinical Presentation in Acute Appendicitis

Area of Science:

• Nuclear medicine
• Oncology
• Gastroenterology

Background:

• Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma.
• F-FDG PET/CT is crucial for staging and assessing treatment response in DLBCL.
• Appendicitis typically presents with right lower quadrant pain and requires prompt diagnosis.

Observation:

• A 53-year-old man with DLBCL underwent F-FDG PET/CT post-chemotherapy.
• The scan revealed complete remission of lymphoma.
• Incidental finding: increased F-18 fluorodeoxyglucose (FDG) uptake in the appendix.

Findings:

• The increased appendiceal FDG uptake was noted in an asymptomatic patient.
• The patient subsequently developed classic symptoms of acute appendicitis six days later.
• This highlights FDG uptake as a potential early indicator of appendicitis.

Implications:

• Increased FDG uptake in the appendix may be an early sign of appendicitis, preceding clinical symptoms.
• This observation could refine the interpretation of incidental appendiceal findings on PET/CT scans.
• Further research may explore FDG PET/CT's role in predicting or diagnosing appendicitis.