Cholesterol Granuloma Unusual Pitfall for Hodgkin Lymphoma Evaluation With 18F-FDG PET/CT

Cholesterol granuloma (CG) is a foreign body-type granuloma that forms in response to cholesterol crystals. Its etiology and pathogenesis are unclear. F-18-FDG is not a tumor-specific agent. Fibroblasts, macrophages, and multinucleated giant cells also take up F-18-FDG. Like sarcoid granulomas or fibrous dysplasia, CG avidly takes up F-18-FDG and can mimic tumor involvement. We present 2 cases of histologically proven CG, which has been misinterpreted as active residual Hodgkin lymphoma lesion.

Automated summary

Cholesterol granuloma (CG) is a type of foreign body-type granuloma that forms in response to cholesterol crystals, which can mimic tumor involvement due to its avid uptake of F-18-FDG, similar to sarcoid granulomas or fibrous dysplasia.