Splenic Granulomatous Lesions Mimicking Metastases on 18F-FDG PET/CT in a Patient With Ovarian Cancer

A 76-year-old woman with a history of ovarian cancer underwent ¹⁸ F-FDG PET/CT due to increased CA199 levels in routine surveillance. PET/CT demonstrated multiple hypermetabolic lesions in the spleen, as well as reactive changes of hypermetabolic lymph nodes in the mediastinal and bilateral hilar region. Histopathologic examination of the splenectomy specimen confirmed granulomatous lesions, which can be easily misinterpreted as metastases.