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Indian J Nucl Med. 2019 Jul-Sep;34(3):216-219. doi: 10.4103/ijnm.IJNM_29_19.

Mesenteric Tuberculosis Masquerading as Carcinoid Tumor on Conventional Imaging and DOTANOC Positron Emission Tomography/Computed Tomography: Uncommon Presentation of a Common Disease.

Author information

1
Department of Radio-Diagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
2
Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
3
Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.

Abstract

Carcinoid tumor of the mesentery has a classical imaging morphology. A specific diagnosis can often be provided on the basis of clinical history, elevated serum neuroendocrine markers, and uptake on somatostatin receptor-based radiotracer studies. Although a number of inflammatory and neoplastic conditions may mimic carcinoid tumor on many of these modalities, uptake on 68Ga-DOTANOC positron emission tomography/computed tomography (PET/CT) is considered specific. We report a case of a 28-year-old male presenting with a mesenteric mass along with elevated serum neuroendocrine markers and uptake on DOTANOC PET/CT, all suggestive of carcinoid tumor. However, the histopathologic examination after surgical resection revealed necrotizing granulomas consistent with tuberculosis (TB). This case highlights the great masquerader that TB can be and stresses the importance of keeping a high index of suspicion for TB, especially in endemic areas.

KEYWORDS:

Carcinoid tumor; gastrointestinal tuberculosis; mesenteric lymphadenitis; radionuclide imaging; somatostatin receptor

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