Abstract
FDG PET/CT in a patient with colonic carcinoma. Mesenteric benign processes as ML should be taken into account as possible pitfalls when 18F-FDG PET/CT is performed for tumor staging. A 77-year-old male patient underwent fluorine-18uorodeoxyglucose positron emission tomography/computed omography (18F-FDG PET/CT) for staging a colonic carcinoma etected by endoscopy in the transverse colon. Before 18F-FDG njection the patient fasted for at least 6 h and he presented lucose blood levels corresponding to 91 mg/dL at the time of the adiopharmaceutical injection. Images were acquired 1 h after ntravenous injection of 290 MBq of 18F-FDG according to the ody mass index. 18F-FDG PET/CT revealed two areas of increased adiopharmaceutical uptake corresponding to a 2 cm hyperdense odule in the transverse colon and a 3 cm hypodense mesenteric odule, respectively (Fig. 1A–E). Based on these findings the atient underwent surgical resection of the colonic nodule with istology confirmation of a colonic carcinoma (Fig. 1F). Furtherore the patient underwent surgical resection of the mesenteric odule which was suspicious for malignancy based on the PET nding. However histology revealed the presence of a mesenteric ipogranuloma (Fig. 1G). Mesenteric lipogranuloma (ML) is a benign inflammatory disase in the mesentery of the bowel and it is a quite rare diagnosis. ore than 200 cases have been reported in the worldwide literaure, but its prevalence is likely underestimated.1 The differential iagnosis of ML includes all disorders that can affect the mesentery uch as lymphoma, liposarcoma, lipoma, peritoneal carcinomatois, carcinoid tumor, retroperitoneal fibrosis, mesenteric desmoid umor, mesenteric inflammatory pseudotumor, mesenteric fibroatosis and mesenteric edema.2 It is well known that inflammatory diseases may cause false postive findings for malignancy at 18F-FDG PET/CT due to the increased adiopharmaceutical uptake by inflammatory cells.3
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