Dual Time Point (18)F-FDG PET/CT Imaging Identifies Bilateral Renal Tuberculosis in an Immunocompromised Patient with an Unknown Primary Malignancy

(18)F-FDG PET/CT imaging is an established imaging modality for cancer staging and response assessment. Its role in identifying infective and inflammatory pathologies from malignancy is debated. Dual time - point imaging is a refined technique used to overcome this interpretational dilemma. We present a 59 year old male with an unknown primary malignancy who was referred for a (18)F-FDG PET/CT imaging. Images revealed primary lung malignancy with co existing bilateral renal tuberculosis which otherwise would have gone amiss or would have been considered as metastases.