FDG-PET/CT findings of Epstein-Barr virus-related lymphoproliferative disorders: Pictorial review

1333 Learning Objectives 1. To understand the pathogenesis of Epstein-Barr virus (EBV) infection and EBV-related lymphoproliferative disorders (LPD). 2. To illustrate representative FDG-PET/CT findings of EBV-related LPD. 3. To review other EBV-related diseases that can be misdiagnosed as LPD. EBV is one of the most common viruses, infecting more than 90% of the adult population worldwide. Although EBV remains latent in most cases, residing in the peripheral blood lymphocytes, EBV becomes active under some circumstances and plays a role in the pathogenesis of LPDs. EBV-related LPDs, which are generally associated with immunocompromised state, include posttransplant lymphoproliferative disorder (PTLD), methotrexate (MTX)-induced LPD, human immunodeficiency virus (HIV)-associated LPD, etc. The incidences of these pathological states have been increasing with the increasing use of therapies such as transplant operations and immunosuppressive treatments. While evaluating the FDG PET/CT images of patients with generalized lymphadenopathy of unknown cause, the possibility of EBV-related LPD should be considered in some patients, and a careful review of the background and previous history of these patients is necessary. In this educational exhibition, we present exhibits illustrating the pathogenesis of EBV-related LPD and representative FDG-PET/CT images from patients with these disorders. In addition, we present a review on other EBV-related diseases such as lymphomas, other malignancies, infectious mononucleosis, and chronic active EBV infection as pitfalls in the diagnosis of LPD by FDG-PET/CT. The goal of this exhibition is that nuclear medicine physicians can appropriately suggest EBV-related LPD and contribute to rapid diagnosis and treatment of these disorders.