Chest Wall Hibernoma With Intense 18 F-FDG Uptake on PET/CT Mimicking Malignant Pleural Mesothelioma

Clin Nucl Med. 2026 Aug 1;51(8):718-719. doi: 10.1097/RLU.0000000000006492. Epub 2026 Apr 16.

Abstract

A man in his 60s with asbestos exposure and pleural plaques was incidentally found to have a chest wall mass on computed tomography (CT). Positron emission tomography/CT (PET/CT) demonstrated intense 18 F-fluorodeoxyglucose (FDG) uptake, raising concern for malignancy, including malignant pleural mesothelioma. CT and magnetic resonance imaging (MRI), however, showed a predominantly fat-containing lesion, suggesting hibernoma. Video-assisted thoracoscopic resection was performed, and histopathology confirmed hibernoma. Recognition of macroscopic fat on CT/MRI is essential to avoid misdiagnosis of FDG-avid benign lipomatous tumors.

Keywords: hibernoma; lipomatous tumor.

Publication types

  • Case Reports

MeSH terms

  • Biological Transport
  • Diagnosis, Differential
  • Fluorodeoxyglucose F18* / metabolism
  • Humans
  • Lipoma* / diagnostic imaging
  • Lipoma* / metabolism
  • Lung Neoplasms* / diagnostic imaging
  • Male
  • Mesothelioma* / diagnostic imaging
  • Mesothelioma, Malignant
  • Middle Aged
  • Pleural Neoplasms* / diagnostic imaging
  • Positron Emission Tomography Computed Tomography*
  • Thoracic Wall* / diagnostic imaging

Substances

  • Fluorodeoxyglucose F18

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