PMC10264663_01
A 55-year-old man presented with a fever for 1 month. Routine diagnostic testing for fever of unknown origin (FUO) did not lead to the diagnosis of etiology. The patient was referred to the Department of Nuclear Medicine for an 18F-FDG PET/CT scan (axial CT, enhanced CT, PET, fusion, and maximum intensity projection (MIP)). Axial non-contrast CT (A) only revealed splenomegaly. However, PET (E) and fusion (F) images showed diffuse FDG uptake in the enlarged spleen with a maximum standardized uptake value (SUV max) of 6.6. The MIP image (G) displayed increased FDG uptake in the enlarged spleen, accompanied by multiple low-density nodules with delayed enhancement on abdominal enhanced CT (B-D), which were similar to those found in lymphoma. Based on pathological examination, a diagnosis of visceral leishmaniasis (VL) was made following splenectomy. The patient received treatment with amphotericin B and was discharged from hospital without fever.
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An enhanced CT scan was performed, which showed an enlarged spleen with sustained strengthening multinodular ( Figures 1B-D ), and angioma was suspected. The patient received a positron emission tomography-computed tomography (PET/CT), which showed a significant diffuse increase in the uptake of FDG in the splenomegaly and slightly diffuse FDG uptake in the bone marrow ( Figures 1A, E-G ).