Epstein-Barr Virus–Positive Mucocutaneous Ulcer Mimicking Rectal Carcinoma at 18F-FDG PET/CT

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We report focally intense 18F-FDG PET/CT rectal activity (SUVmax = 25) with a horseshoe distribution in an 81-year-old man with B-cell chronic lymphocytic leukemia and suspected Richter transformation. While imaging findings were typical for rectal adenocarcinoma, histology revealed Epstein-Barr virus–positive mucocutaneous ulcer.

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