Gallium-67 scintigraphy and F-18 fluorodeoxyglucose position emission tomography in posttransplant lymphoproliferative disorder

A 21-year-old man, who underwent heart transplantation 5 years earlier because of dilated cardiomyopathy, was admitted for recent onset of intermittent abdominal pain and poor appetite. Whole-body Ga-67 scintigraphy showed intense gastrointestinal uptake. Fluorodeoxyglucose position emission tomography (FDG PET) revealed hypermetabolism in the left lower neck, mediastinum, stomach, and extensively in a bowel loop. The histologic findings of a gastric biopsy through endoscopy disclosed the typical "starry sky" appearance of Burkitt's lymphoma. Based on these findings, the patient was diagnosed as having a posttransplant lymphoproliferative disorder. Chemotherapy was then arranged for subsequent treatment.