PMC4899851_01
77-year-old male with bladder diverticulitis. Initial PET/CT demonstrates a bladder diverticulum in the posterolateral aspect of the left side of the bladder. Radioactive urine is seen within the lumen of the diverticulum and within the lumen of the bladder, indicating free communication between the two structures. The CT image (upper left corner) demonstrates that the fat surrounding the diverticulum is clean, without any evidence of fatty infiltration.
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However, there was an incidental bladder diverticulum in the posterolateral aspect of the left side of the bladder without evidence of surrounding fatty infiltration (Fig. 1).
77-year-old male with bladder diverticulitis. Followup PET/CT approximately one year after PET/CT in Figure 1 again demonstrates a bladder diverticulum in the posterolateral aspect of the left side of the bladder that freely communicates with the bladder lumen. The CT image (upper left corner) demonstrates very mild haziness of the fat surrounding the diverticulum, suggesting mild inflammatory/infectious changes. Heterogeneous bladder-wall thickening suggests chronic bladder outlet obstruction.
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Approximately one year later, another followup PET/CT demonstrated no imaging evidence of recurrent lymphoma in the neck, chest, abdomen, or pelvis; however, the bladder diverticulum was demonstrated again, with interval development of mild haziness of the fat surrounding the diverticulum (Fig. 2).
77-year-old male with bladder diverticulitis. Followup PET/CT approximately one year after PET/CT in Figure 2 again demonstrates a bladder diverticulum in the posterolateral aspect of the left side of the bladder that freely communicates with the bladder lumen. The CT image (upper left corner) demonstrates interval development of extensive fatty infiltration surrounding the diverticulum consistent with inflamed perivesicle fat and highly suggestive of bladder diverticulitis.
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After an additional year, a followup PET/CT (Fig. 3) demonstrated no evidence of recurrent lymphoma; however, there was interval development of faint mucosal enhancement of the bladder diverticulum and extensive fatty infiltration surrounding the diverticulum, consistent with inflamed perivesicle fat and highly suggestive of bladder diverticulitis.