Interesting ImagesInverted FDG Uptake Pattern in Subcutaneous Panniculitis-Like T-Cell LymphomaKoyasu, Sho MD, PhD∗; Sugimoto, Akihiko MD†; Nakamoto, Yuji MD, PhD∗ Author Information From the Departments of ∗Diagnostic Imaging and Nuclear Medicine †Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto City, Japan. Received for publication July 18, 2022; revision accepted September 12, 2022. Conflicts of interest and sources of funding: The authors have no conflicts of interest. The present study was financially supported by JSPS KAKENHI (grant number 22K15879). Correspondence to: Sho Koyasu, MD, PhD, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto City, 606-8507, Japan. E-mail: [email protected]. Clinical Nuclear Medicine 48(2):p 186-187, February 2023. | DOI: 10.1097/RLU.0000000000004451 Buy Metrics Abstract A 47-year-old woman presented with a 2-month history of subcutaneous nodules, erythema, and fever. 18F-FDG PET images demonstrated inverted FDG uptake pattern corresponding to the subcutaneous lesion against lymph nodes. The specimen of the inguinal lesion showed massive infiltration of small lymphocytes in the adipose tissue with rimming adipocytes, whereas very few tumor cells infiltrated the lymph nodes. Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) was diagnosed. SPTCL normally shows quite interesting distribution of tumor cells, that is, lymph node involvement is usually absent. Therefore, this case highlighted the importance of the inverted accumulation pattern on FDG PET to suspect SPTCL. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.