FIGURE 2. Lung carcinoma (not shown) in right lung with focal increased ¹⁸F-FDG accumulation in left lower neck. (A) Transverse PET. (B) Transverse CT. (C) Integrated transverse PET/CT image of lower neck. Integrated PET/CT imaging ruled out N3 stage. PET/CT revealed that increased ¹⁸F-FDG accumulation in neck was localized in the intrinsic laryngeal muscles. Finding was result of compensatory laryngeal muscle activation caused by contralateral recurrent laryngeal nerve palsy from direct nerve invasion by lung cancer.