An Interesting Case of Inflammatory Myofibroblastic Tumor Masquerading as Lymphoma Detected on 18F-FDG PET-CT

Inflammatory myofibroblastic tumors (IMT) are a rare set of tumors that have been reported in various areas of the body but not quite as often in systemic lymph nodes. Herein, we discuss the case of a 60-year-old woman who presented with bilateral cervical and axillary lymphadenopathy and a low-grade fever. She subsequently underwent a fluorine-18-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) as part of her evaluation. The scan revealed multiple hypermetabolic cervical, axillary, mediastinal, retroperitoneal, pelvic, and inguinal lymph nodes of various dimensions scattered throughout her body. Based on these findings, she was erroneously diagnosed to have lymphoma. It was only after histopathological correlation was the diagnosis revised to that of IMT, after which she was started on a course of oral corticosteroids. On follow-up imaging, she showed evidence of complete resolution of the involved lymph nodes. She has been disease-free for the past nine months after completing treatment. This case highlights the importance of including IMT as part of the differential diagnosis in suspected cases of lymphoma, giving credence to the phrase “all that glitters is not gold.”