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

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Rationale:18F-fluorodeoxyglucose (18F-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 18F-FDG activity in previous operation site of aortobiiliac bypass graft in the initial staging of small cell lung cancer (SCLC).Diagnoses:Based on 18F-FDG PET/CT examination, preliminary differential diagnosis was AGI.Interventions:We performed laboratory tests and 67Galliun-citrate (67Ga) 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, 67Ga planar scintigraphy and SPECT/CT imaging of the abdomen and pelvis failed to show abnormal 67Ga uptake in the same site of aortobiiliac bypass graft with 18F-FDG uptake.Lessons:We present a case with postoperative inflammatory aortobiiliac bypass graft which was misdiagnosed as AGI based on intense 18F-FDG activity seen at PET/CT imaging.

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