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Background The F-18 fluorodeoxyglucose positron emission/computed tomography (FDG PET/CT) has become an established diagnostic imaging for malignancy. However, there are other diseases that can also be identified with FDG, some of them are infections such as tuberculosis. Case presentation In this case report, two patients showed multiple hypermetabolic tuberculosis lesions on FDG PET/CT, with one of the patients having history of malignancy. The objective of the present case report is to emphasize the need to use other differential diagnosis techniques for tuberculosis especially in tuberculosis-endemic countries when interpreting FDG PET/CT. Conclusion By analyzing diagnostic imaging alone, there is a high chance of misinterpreting asymptomatic tuberculosis patient as having malignancy. Therefore, there is need for correlation with clinical data as well as other imaging modalities and PET/CT with more specific tracer in order to differentiate malignancy from benign disease such as tuberculosis.

Methods 24 primary and pre-treated patients diagnosed with multiple myeloma according to the International Myeloma Working Group criteria were examined by F-FDG PET/CT and whole-body MRI including DWI (b= 0, and b= 800 s/mm). F-FDG PET/MRI was used to achieve correct matching of findings in the corresponding PET/ CT study. Suspicious lesions were defined by the imaging gold-standard of nonenhanced T1-w/T2-wMRI and low-dose CT.