Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis on 68Ga-FAPI-04 and 18F-FDG PET/CT

We report a case of tuberculosis peritonitis in a 26-year-old woman who presented with abdominal pain, fatigue, and weight loss for the last 4 months. Abdominal US and CT demonstrated intra-abdominal massive ascites, misty mesentery, and diffuse peritoneal thickening. In addition, 3 nodular lesions were detected in the right lung. 18 F-FDG PET/CT showed hypermetabolism in lung nodules, mesenteric area, peritoneal thickening, and ascites. 68 Ga-FAPI-04 (fibroblast activation protein-specific inhibitor) PET/CT imaging was also performed; high uptakes were detected in the same regions of 18 F-FDG PET/CT. Tuberculosis diagnosis was made after histopathological examination of wedge resection of the right lung.