A 57-year-old man with an adenocarcinoma of the prostate, presented with multiple lymph nodes in the para-aortic and right iliac region on computer tomography (CT). However, since the radiologic images were taken 3 weeks following an urosepsis, the differentiation between inflamed and metastatic lymph nodes is difficult. Thus, an integrated [C] choline positron emission tomography and computer tomography (PET/CT) was performed, showing multiple lymph nodes. The patient was staged as cT3N1M0 and treated with hormonal therapy. The choline PET/CT performed after hormonal treatment showed no more hypermetabolic lymph nodes. This case substantiate the hypothesis that choline PET/CT could be used to evaluate therapy response in prostate cancer patients.