Search tips
Search criteria 


Logo of diagnoMDPI Open Access Journalsdiagnosticshomethis articlethis journalinstructions for authorssubscribe
Diagnostics (Basel). 2016 June; 6(2): 18.
Published online 2016 May 12. doi:  10.3390/diagnostics6020018
PMCID: PMC4931413

18F-FDG PET/CT Findings in Acute Epstein-Barr Virus Infection Mimicking Malignant Lymphoma

Markus Schwaiger, Academic Editor


We present a case demonstrating the diagnostic work-up and follow-up of a patient with acute Epstein-Barr virus (EBV) infection in which the clinical picture and imaging on 18F-FDG PET/CT mimicked malignant lymphoma. Follow-up 18F-FDG PET/CT scan in the patient performed 7 weeks after the abnormal scan revealed complete resolution of the metabolically active disease in the neck, axillas, lung hili, and spleen. This case highlights inflammation as one of the most well established false positives when interpreting 18F-FDG PET/CT scans.

Keywords: Epstein-Barr virus, 18F-FDG PET/CT, lymphadenopathy, infectious mononucleosis, malignant lymphoma
Figure 1
A 21-year-old man presented with 6 weeks of unexplained fever, pharyngitis, enlarged cervical neck lymph nodes, night sweats and severe fatigue. The patient was treated as an outpatient with antibiotics for acute tonsillitis twice without any improvement. ...
Figure 2
Additional diagnostic workup drawn a day prior to the 18F-FDG PET/CT became available showing positive EBV VCA-IgM and negative EBV VCA-IgG indicating acute infectious mononucleosis. CMV-IgM was furthermore positive. HIV and hepatitis panels were negative. ...

Conflicts of Interest

Conflicts of Interest

The authors declare no conflict of interest.


1. Thomas D.L., Syrbu S., Graham M.M. Epstein-Barr virus mimicking lymphoma on FDG-PET/CT. Clin. Nucl. Med. 2009;34:891–893. doi: 10.1097/RLU.0b013e3181bed135. [PubMed] [Cross Ref]
2. Tamai K., Koyama T., Saga T., Umeoka S., Aoyama A., Hanaoka N., Fukuse T., Wada H., Tachibana M., Togashi K. Posttransplant lymphoproliferative disorder in a lung transplant recipient. J. Thorac. Imaging. 2005;20:280–283. doi: 10.1097/01.rti.0000187436.99137.5e. [PubMed] [Cross Ref]
3. Tomas M.B., Tronco G.G., Karayalcin G., Palestro C.J. 22. FDG uptake in infectious mononucleosis. Clin. Positron Imaging. 2000;3:176. doi: 10.1016/S1095-0397(00)00088-1. [PubMed] [Cross Ref]
4. Rosenbaum S.J., Lind T., Antoch G., Bockisch A. False-positive FDG PET uptake-the role of PET/CT. Eur. Radiol. 2006;16:1054–1065. doi: 10.1007/s00330-005-0088-y. [PubMed] [Cross Ref]
5. Lustberg M.B., Aras O., Meisenberg B.R. FDG PET/CT findings in acute adult mononucleosis mimicking malignant lymphoma. Eur. J. Haematol. 2008;81:154–156. doi: 10.1111/j.1600-0609.2008.01088.x. [PubMed] [Cross Ref]
6. Jacene H.A., Stearns V., Wahl R.L. Lymphadenopathy resulting from acute hepatitis C infection mimicking metastatic breast carcinoma on FDG PET/CT. Clin. Nucl. Med. 2006;31:379–381. doi: 10.1097/01.rlu.0000222675.10765.14. [PubMed] [Cross Ref]

Articles from Diagnostics are provided here courtesy of Multidisciplinary Digital Publishing Institute (MDPI)