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18F-FDG Uptake in Subcutaneous Fat Preceding Clinical Diagnosis of Human Immunodeficiency Virus–Associated Lipodystrophy

Caton, Michael T. Jr, MD; Miskin, Nityanand, MD; Hyun, Hyewon, MD

doi: 10.1097/RLU.0000000000002298
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A 62-year-old man with human immunodeficiency virus (HIV) on long-standing highly active antiretroviral therapy presented for 18F-FDG PET/CT evaluation of a pulmonary nodule. The examination showed unusual radiotracer distribution accumulating in the subcutaneous and visceral fat with low cerebral and skeletal muscle uptake. Imaging features were consistent with HIV-associated lipodystrophy, an unsuspected diagnosis that was later confirmed on physical examination. Recognition of HIV-associated lipodystrophy by the nuclear medicine physician is critical as altered biodistribution may affect diagnostic yield or be mistaken for infectious pathology.

From the Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Received for publication July 23, 2018; revision accepted August 25, 2018.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Michael T. Caton Jr, MD, Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115. E-mail:

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