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Clinical Significance of Small Pulmonary Nodules with Little or No 18F-FDG Uptake on PET/CT Images of Patients with Nonthoracic Malignancies

Joo Hyun O, Ie Ryung Yoo, Sung Hoon Kim, Hyung Sun Sohn and Soo Kyo Chung

Department of Radiology, The Catholic University of Korea, Seoul, Korea


Figure 1
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  		FIGURE 1.  Fibrotic scar (arrow) is present in right middle lobe on lung setting window CT image (A) of 42-y-old female breast cancer patient with past history of modified radical mastectomy, chemotherapy, and radiation therapy. PET/CT fusion images show small nodule in right upper lobe (B, arrow) and another in right middle lobe (C, arrow) without any 18F-FDG uptake on PET images (D and E). Follow-up lung CT images demonstrated no difference in size and shape of these nodules for >27 mo (image not shown), and nodules were presumed to be benign.

 

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  		FIGURE 2.  Fibrotic scars are present in left apex on lung setting CT image (A) of 44-y-old male colon cancer patient with past history of right hemicolectomy and chemotherapy. PET/CT fusion image (B) shows small nodule in left upper lobe (arrow) without any 18F-FDG uptake on PET image (C). On follow-up PET/CT (D) and PET (E) images performed 5 mo later, left upper lobe nodule demonstrates increased size and 18F-FDG uptake, indicating malignancy (arrow).

 

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  		FIGURE 3.  PET/CT fusion (A) and PET (B) images of 52-y-old female breast cancer patient who underwent modified radical mastectomy show solitary nodule with faintly perceptible 18F-FDG uptake in right upper lobe (arrow). Wedge resection confirmed metastatic adenocarcinoma.

 

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  		FIGURE 4.  PET (A) and PET/CT fusion (B) images of 73-y-old male patient who received chemotherapy and radiation therapy for sigmoid colon cancer demonstrate solitary nodule measuring 1 cm in diameter with faint 18F-FDG uptake in right upper lobe (arrow). Eosinophilic lung disease was diagnosed after correlation with laboratory results and clinical course.

 




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