Key result
18F-Piflufolastat PET/CT detects incidental PSMA uptake in interatrial septum lipomatous hypertrophy, mimicking a malignant mass.
Why the study?
PET/CT with 18F-Piflufolastat shows activity in benign conditions, and recognizing uptake in lipomatous hypertrophy of the interatrial septum avoids confusion with a malignant cardiac mass.
Case Report (n=1)
Lipomatous hypertrophy of the interatrial septum can show incidental PSMA uptake on PET/CT, which should be recognized to avoid misdiagnosis of a malignant cardiac mass and unnecessary interventions.
Answers are grounded in this paper and cite their sources.
Awareness of this uptake pattern may avert misdiagnosis of cardiac masses; case reports leave open its prevalence and impact.
PET/CT with 18F-Piflufolastat (18F-DCFPyL, trade name Pylarify) is performed to identify areas of metastatic prostate cancer. However, activity is seen in many additional organs and benign conditions. This case illustrates PSMA activity associated with lipomatous hypertrophy of the interatrial septum (LHIS), a benign, usually incidental and asymptomatic lesion with well-known uptake on FDG PET/CT. This is a potential pitfall in the interpretation of PSMA PET/CT, which should not be confused with a malignant cardiac mass. Awareness of this source of activity avoids unnecessary intervention or additional imaging.
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DeSai et al. (2026) conducted a case report in Lipomatous hypertrophy of the interatrial septum (n=1). 18F-Piflufolastat (18F-DCFPyL) PET/CT was evaluated. 18F-Piflufolastat PET/CT can demonstrate incidental PSMA uptake in lipomatous hypertrophy of the interatrial septum, which is a potential pitfall that mimics a malignant cardiac mass.
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