Gastrinoma With Local Metastatic Lymph Node Causing Zollinger-Ellison Syndrome: CT Imaging, PET Diagnosis
Introduction A 63-year-old woman arrives with abdominal pain, vomiting, and intermittent diarrhea. She has a history of diabetes, hypertension, and GERD. At first glance, this may appear to be common gastroenteritis, medication-related gastritis, or peptic ulcer disease. But advanced medical imaging , laboratory evaluation, and nuclear medicine reveal a much rarer cause: gastrinoma with local metastatic lymph node causing Zollinger-Ellison syndrome (ZES). This case highlights one of the most important truths in radiology interpretation and CT scan diagnosis : common symptoms can hide uncommon disease. Gastrinoma is a rare neuroendocrine tumor that secretes gastrin, causing uncontrolled gastric acid production. The result can be recurrent ulcers, severe diarrhea, intestinal inflammation, and life-threatening complications. Detecting these tumors requires high clinical suspicion and modern imaging such as contrast CT, MRI, endoscopy, and 68Ga-DOTATATE PET/CT . For clinicians...