FDG Avid Plugoma Mimicking Recurrent Lymphoma

A 60-year-old male with HIV and Hodgkin lymphoma underwent surveillance fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) after chemotherapy. Imaging revealed focal FDG uptake (SUVmax 3.5) in a 3.0 cm heterogenous soft-tissue mass in the right inguinal region, raising concern for lymphoma recurrence. Surgical history revealed right inguinal herniorrhaphy with mesh placement three months earlier. The lesion localized precisely to the mesh site and was consistent with a postoperative plugoma. The diagnosis was based on imaging and supported by follow-up computed tomography. Plugomas are benign inflammatory masses at mesh sites that often show FDG avidity on PET/CT. Awareness of surgical history is critical for radiologists and clinicians to prevent misdiagnosis and avoid unnecessary biopsies or treatment.