Early acute cerebral ischemia can present as transitory FDG uptake on PET/CT mimicking lymphoma, requiring MRI confirmation to avoid misinterpretation.
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MRI confirmation needed for hypermetabolic brain lesions on FDG PET/CT; case report leaves open prevalence and generalizability.
A 50-year-old man with angioimmunoblastic T-cell lymphoma in complete response to treatment presented new hypermetabolic brain lesions on 18F-FDG PET/CT suggestive of malignancy. These findings were correlated by MRI that showed cortical-subcortical peripheral lesions typical of acute ischemic infarction. A restaging 18F-FDG PET/CT showed that hypermetabolic lesions were replaced by ametabolic areas, supporting chronic infarction. Early ischemia presents transitory FDG increase. Brain lymphomas are highly FDG avid and difficult to differentiate from acute cerebral infarction. In view of the discordance of abnormal areas of intracranial uptake on PET FDG, MRI confirmation is required to avoid misinterpretation.
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Fernández‐Rodríguez et al. (2021) studied this question.
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