Fig. 5.

HIV positive patient with SCC of the left piriform sinus. a Axial PETCT illustrates a nodular area of high FDG uptake at left level II (asterisk) and bilateral nodular areas of symmetrical high FDG uptake laterally in the neck (arrows). There is an additional nodular area of high FDG uptake in the right retropharyngeal region (arrowhead). All nodular areas of high FDG uptake appear to represent metastatic adenopathy. b Corresponding axial CECT image shows an enlarged enhancing left level II node (asterisk). No suspicious adenopathy is seen at the other sites of increased FDG uptake including the lateral sides of the neck as well as the right retropharyngeal region. c Corresponding coronal PET/CT image confirms the linear nature of the foci of high FDG uptake in both sternocleidomastoid muscles (arrow) and in the right longus colli muscle (arrowheads). Areas of avid nodular FDG uptake are seen at left level II and III (asterisks). d Corresponding coronal CECT image confirms that the linear areas of FDG uptake correspond to neck muscles. Metastatic cervical adenopathy is confirmed at left level II and III (asterisks). The high uptake in the right longus colli and bilateral sternocleidomastoid muscles was related to involuntary contraction in this very anxious patient