Intense (18)F-FDG activity in aortoiliac bypass graft mimicking infection: A case report

RATIONALE: (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) has the potential to become an important imaging tool for the diagnosis of suspected aortoiliac bypass graft infection (AGI). PATIENT CONCERNS: A 76-year-old man presented with incidental findings of intense (18)F-FDG activity in previous operation site of aortobiiliac bypass graft in the initial staging of small cell lung cancer (SCLC). DIAGNOSES: Based on (18)F-FDG PET/CT examination, preliminary differential diagnosis was AGI. INTERVENTIONS: We performed laboratory tests and (67)Galliun-citrate ((67)Ga) single photon emission computed tomography/computed tomography (SPECT/CT). OUTCOMES: He had no constitutional symptoms and abnormal laboratory test results suggesting AGI. CT scan of the abdomen and pelvis showed no abnormal findings. Also, (67)Ga planar scintigraphy and SPECT/CT imaging of the abdomen and pelvis failed to show abnormal (67)Ga uptake in the same site of aortobiiliac bypass graft with (18)F-FDG uptake. LESSONS: We present a case with postoperative inflammatory aortobiiliac bypass graft which was misdiagnosed as AGI based on intense (18)F-FDG activity seen at PET/CT imaging.