PT  - JOURNAL ARTICLE
AU  - Joseph Trak
AU  - Munir Ghesani
TI  - <strong>A Sheep in Wolf’s Clothing: Beware of Physiologic Ureteric Activity Mimicking a Pathologic Lymph Node!</strong>
DP  - 2022 Jun 01
TA  - Journal of Nuclear Medicine
PG  - 2703--2703
VI  - 63
IP  - supplement 2
4099  - http://jnm.snmjournals.org/content/63/supplement_2/2703.short
4100  - http://jnm.snmjournals.org/content/63/supplement_2/2703.full
SO  - J Nucl Med2022 Jun 01; 63
AB  - 2703 Introduction: Learning Objectives:Review ureteric anatomy throughout its course from the renal pelvis to the vesicoureteral junction. Describe and illustrate the physiologic constrictions along the urinary collecting system that can mimic metastatic lymph nodes. Highlight techniques to avoid misinterpretation of physiologic ureteric activity as pathologic lymph nodes. Review strategies to avoid misinterpretation of pathologic lymph nodes as physiologic ureteric activity.Methods: Various Pylarify and FDG PET/CT images were reviewed and 2-3 cases that fulfilled each of the following criteria were selected. One case to illustrate physiologic ureteric traversal, a second case to illustrate the three physiologic ureteral constrictions, and a third case to illustrate abdominal and pelvic lymph nodes. Results: N/AConclusions: Avoiding misinterpreting urine-containing ureteral activity for pathologic lymph nodes, can be achieved by the following. Firstly, assessing whether the lesion displays radiographic continuity or whether it only exists in a few PET/CT slices. Secondly, viewing the radiographic images in coronal view further assists in visualization, aiding in differentiating ureters from pathologic lymph nodes.