Interesting ImagesAn Unusual Case of Maxillary Sinus Cholesterol Granuloma Showing FDG Uptake on PET/CTUmeda, Naoki MD∗,†; Hayama, Masaki MD, PhD∗; Nakamura, Akiko MD∗; Maeda, Yohei MD, PhD∗; Inohara, Hidenori MD, PhD∗Author Information From the ∗Department of Otorhinolaryngology–Head and Neck Surgery, Osaka University Graduate School of Medicine †Department of Otolaryngology, Suita Municipal Hospital, Suita City, Osaka, Japan. Received for publication June 24, 2020; revision accepted August 24, 2020. Conflicts of interest and sources of funding: This work was supported by JSPS KAKENHI grant (no. 19K09890). None declared to all authors. Correspondence to: Masaki Hayama, MD, PhD, Department of Otorhinolaryngology–Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita City, Osaka 565-0871, Japan. E-mail: [email protected]. Clinical Nuclear Medicine: February 2021 - Volume 46 - Issue 2 - p e131-e132 doi: 10.1097/RLU.0000000000003327 Buy Metrics Abstract Cholesterol granuloma (CG) occurs primarily in the middle ear and rarely in the paranasal sinus. We report an unusual case of paranasal sinus CG with 18F-FDG uptake. A 76-year-old man presented with right refractory epistaxis. PET/CT showed FDG uptake in the maxillary sinus. CT findings are typically uncharacteristic, whereas MRI scans are characterized by a high signal on both T1-weighted and T2-weighted images. Nasal endoscopy from the ostium revealed a granulomatous lesion with hemorrhage at the base of the maxillary sinus. After pathological examination by endoscopic sinus surgery, the patient was diagnosed with CG. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.