The C-X-C motif chemokine receptor 4 (CXCR4) is expressed by a variety of inflammatory and malignant cells. We report the case of a 54-year-old woman with recurrent urinary tract infection who underwent a Ga-pentixafor PET/CT for detection of occult infectious foci. As a secondary finding, multiple CXCR4 abdominal lesions could be seen, consistent with the diagnosis of long-known posttraumatic splenosis. It is important to be aware that CXCR4-directed imaging may identify splenic tissue based on the presence of inflammatory cells and that both benign and malignant cells may show CXCR4 expression to avoid misinterpretation.