¹⁸F-FDG PET/CT findings in a rare monomorphic epitheliotropic intestinal T cell lymphoma

Excerpt

A 57-year-old man presented with a 3-month history of bloody diarrhea, abdominal pain, and urological symptoms including dysuria, frequency and urgency, and weight loss of 15 kg. Painless colonoscopy showed rough mucosa with multiple shallow ulcerations in the ileocecum, entire colon, and rectum. Colorectal biopsies revealed ulcerative colitis. Both unenhanced abdominal CT scan and ultrasonic examination of the urinary system displayed no abnormalities. Chest CT images showed some nodules and multiple patchy shadows in both lungs, which suggested the possibility of infectious lesions. To rule out malignancy, the CT-guided percutaneous lung puncture biopsy was recommended. But the patient refused to perform a biopsy. The T-SPOT test for tuberculosis infection was positive. Therefore, intestinal tuberculosis was suspected. The patient received anti-tuberculosis treatment for 1 month. However, his clinical symptoms did not improve. Colonoscopy was performed once again. Unexpectedly, the pathological examination of rectal biopsy specimens confirmed the lesion to be monomorphic epitheliotropic intestinal T cell lymphoma (MEITL). Furthermore, the patient received gastroscopy and the histopathological features of gastric biopsy specimens were consistent with that of MEITL. …