Rather than a malignant mass, there are features typical of endplate osteomyelitis, i.e. a destructive process centred on the disc with secondary bone collapse and a large paravertebral cuff-like soft tissue mass containing fluid (rim enhancing) consistent with pus. Neutrophils utilise glucose at a similarly increased rate to malignant cells so they are highly FDG avid thus a potential false positive for malignancy.