Peeyush Bhargava

A 20-year-old woman underwent evaluation for cardiopulmonary symptoms initially attributed to pulmonary embolism of uncertain chronicity. Positron emission tomography/computed tomography (PET/CT) revealed an intensely fluorodeoxyglucose (FDG)-avid mass within the right pulmonary artery, suggestive of a malignant process. Surgical resection and histopathologic examination confirmed high-grade spindle cell sarcoma with developing pulmonary infarcts. This case highlights the role of PET/CT in distinguishing a malignant intravascular tumour from thrombus in atypical presentations.

Although uterine leiomyomas (fibroids) are benign and frequently seen in genitourinary imaging, their degeneration features may overlap with malignant entities. Accurate characterization of uterine fibroids (UFs) and its differentiation from other malignancies not only helps alleviate patients’ anxiety but also assists with treatment plans, either medical or surgical. This article aims to outline the main magnetic resonance imaging characteristics of each fibroid degenerating type with case-based illustrations. This will also outline essential imaging features to differentiate degenerating UFs from other malignant entities.

A 60-year-old male with HIV and Hodgkin lymphoma underwent surveillance fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after chemotherapy. Imaging revealed focal FDG uptake (SUVmax 3.5) in a 3.0 cm heterogenous soft-tissue mass in the right inguinal region, raising concern for lymphoma recurrence. Surgical history revealed right inguinal herniorrhaphy with mesh placement three months earlier. The lesion localized precisely to the mesh site and was consistent with a postoperative plugoma. The diagnosis was based on imaging and supported by follow-up computed tomography. Plugomas are benign inflammatory masses at mesh sites that often show FDG avidity on PET/CT. Awareness of surgical history is critical for radiologists and clinicians to prevent misdiagnosis and avoid unnecessary biopsies or treatment.

A 62-year-old woman with chronic nausea and epigastric pain underwent hepatobiliary scintigraphy. Gallbladder ejection fraction (GBEF) calculation suggested normal function. However, upon further review, a septate gallbladder was identified. This promoted a re-evaluation of the selected region of interest (ROI). The initial ROI included only the gallbladder fundus, leading to GBEF overestimation. Recalculation with a comprehensive ROI that encompassed both compartments yielded a lower GBEF, consistent with biliary dyskinesia or chronic cholecystitis. This case highlights the importance of ROI selection for accurate assessment of GBEF calculation in anatomical variations such as septate gallbladder and correlating functional studies with anatomical imaging.