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

Ali, Syed Zama MD, FRCR*†; Yin, Loi Hoi MD, MRCP, FRCR, MMED; Kin, Khor Lih MBBS, FRCR, MMED, FAMS; Sinha, Arvind Kumar MBBS, EBNM, FAMS; Poon, Li Mei MBBS, MRCP, FRCPath

doi: 10.1097/RLU.0000000000001750
Interesting Images

Acute appendicitis is a clinical diagnosis typically presenting with right lower quadrant pain. We describe the case of an asymptomatic 53-year-old man with stage 2A diffuse large B-cell lymphoma, who underwent 18F-FDG PET/CT at the completion of chemotherapy. The scan showed complete lymphomatous disease remission. Incidentally, there was increased FDG uptake in a tubular structure adjacent to the cecum. Clinical examination was negative. Subsequently, the patient presented 6 days later with typical acute appendicitis symptoms. This case is interesting wherein increased FDG uptake in the appendix predated the appearance of clinical symptoms.

From the *Department of Diagnostic Radiology, Khoo Teck Puat Hospital; and Departments of †Diagnostic Imaging, and ‡Hematology-Oncology, National University Hospital, Singapore.

Received for publication April 10, 2017; revision accepted May 27, 2017.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Syed Zama Ali, MD, FRCR, Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828. E-mail:

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