18F-FDG PET/CT Demonstrates Renal Cell Cancer in a Transplant With Synchronous Intestinal Infection

We present a case of a 22-year-old man with history of allogenic renal transplantation on immunosuppression, who underwent 18F-FDG-PET/CT to characterize a lesion in the transplanted kidney on ultrasonogram and contrast-enhanced computed tomography imaging. PET/CT revealed FDG avid lesion in the transplanted kidney and mural thickening involving the distal ileum, ileocecal junction, and ileocolic lymph nodes. Subsequent histopathological examination from the renal lesion revealed renal cell carcinoma in the transplanted kidney. Additionally, endoscopic biopsy from the ileal thickening revealed granulomatous inflammation, suggesting tuberculosis, which was missed on both ultrasonogram and contrast-enhanced CT imaging. Received for publication August 25, 2018; revision accepted December 24, 2018. Conflicts of interest and sources of funding: none declared. Correspondence to: Bhagwant Rai Mittal, MD, Department of Nuclear Medicine and PET, Post Graduate Institute of Medical Education and Research, Chandigarh-160012, India. E-mail: brmittal@yahoo.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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