Focal Pulmonary 18F-fluorodeoxyglucose Accumulation Without Corresponding Computed Tomography Abnormalities due to Intravenous Injection Passing Through the Lower Limb Varicose Veins

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BT Kung, CP Wong, TK Au Yong, CM Tong

Hong Kong J Radiol 2013;16:301-6

DOI: 10.12809/hkjr1312098

A 58-year-old woman with bilateral lower limb varicose veins and Burkitt lymphoma underwent positron-emission tomography/computed tomography (PET-CT) to exclude lymphoma relapse. PET-CT images did not show any suspicious lesion suggestive of malignancy. However, intense 18F-fluorodeoxyglucose (FDG) uptake focus was detected in the left lung without a corresponding CT abnormality. Follow-up PET-CT 7 weeks later showed disappearance of the 18F-FDG–avid left lung focus, although another new 18F-FDG–avid focus without a corresponding CT abnormality was detected in the right lung. It is possible that these artefacts were due to 18F-FDG–avid microembolus formations, probably related to intravenous 18F-FDG injection into the left foot passing through the varicose veins of the leg. Care should be taken to avoid misinterpreting PET-CT images should a similar situation be encountered in the future.