False positive FDG-PET extensive diffuse abdominal tracer activity in a patient with CLL on whole-body 18FDG-PET/CT indicative of Ritcher's transformation

The authors present a patient with CLL (chronic lymphocytic leukemia)with diffuse high SUV values in the abdomen. These disturbing findings can sometimes lead to unnecessary procedures. Because of the potential for detection of other malignancies, histological confirmation of the cause of abnormal PET findings is always advisable before one decides on subsequent management (9), but not always possible. SUV values are considered pathological whenever focal FDG deposits (not corresponding to normal physiologic uptake or physiologic elimination of FDG) are higher than 2.5-3.0 (the most frequent standard SUV used in the literature to differentiate benign from malignant lesions).