During follow-up of thyroid cancer,
131
I whole-body scan showed intense tracer uptake in the right hemithorax of a patient previously submitted to thyroidectomy and radioiodine therapy for differentiated thyroid cancer. Thyroglobulin was undetectable at the time of the scan. Single-photon emission computed tomography/computed tomography (SPECT/CT) of the thorax correctly identified widespread bronchiectasis
131
I-avid in the middle lobe of the right lung. After bronchoalveolar lavage, a bronchial specimen was positive for
Mycobacterium avium
infection. Hybrid imaging with SPECT/CT allowed to correctly identify a false-positive case of
131
I uptake due to inflammation in a single diagnostic session, minimizing patient discomfort or misdiagnoses.