F-18 fluorodeoxyglucose uptake in atherosclerotic plaque in the mediastinum mimicking malignancy: Another potential for error

Atherosclerosis is an inflammatory process accumulating numerous inflammatory cells such as macrophages and lymphocytes. This cellular infiltrate has a high metabolic demand, which can be reflected on F-18 FDG positron emission tomographic (PET) imaging. The FDG uptake in athdrosclerotic vessels is usually distinguishable as a result of its linear and continuous appearance and mild level of activity. However, occasionally, atherosclerotic plaques present themselves as focal "hot spots," which can be easily misinterpreted as malignancy. This report emphasizes atherosclerotic plaques as a potential pitfall while interpreting FDG scans. It also highlights the importance of radiographic correlation to avoid such an error.