18F-FDG PET Scanning in Pulmonary Amyloidosis

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FIGURE 1.
Images of 78-y-old woman with Sjögren syndrome. (A) High-resolution CT scan of chest demonstrates irregular nodule measuring 2.4 × 1.2 cm and containing air bronchograms in right upper lobe. On resection, nodule proved to be MALT lymphoma with plasmacytic differentiation and associated amyloid. (B) ¹⁸F-FDG PET scan demonstrates increased uptake of ¹⁸F-FDG (SUVmax, 6.7) in right-upper-lobe nodule.

TABLE 1

Demographic, Clinical, and Radiologic Features of 18 Subjects with Pulmonary Amyloidosis

Characteristic	Data
Male sex	9 (50)
Age (y)
Mean ± SD	64.8 ± 13.1
Median	69.5
Range	32–80
Smoking status
Current	2 (11)
Previous	4 (22)
Never	12 (67)
Presenting symptoms
Dyspnea	6 (33)
Cough	5 (28)
Fatigue	2 (11)
None	8 (44)
CT findings
Nodules	14 (78)
Cysts	6 (33)
Interstitial/septal thickening	4 (22)
Bronchiectasis	3 (17)
Lymphadenopathy	3 (17)
Pleural effusion	3 (17)
Emphysema	3 (17)
Pulmonary function^*
Obstruction	6 (43)
Restriction	1 (7)
Reduced DLCO only	1 (7)
Normal	6 (43)

TABLE 2

Characteristics of 8 Subjects with Positive ¹⁸F-FDG PET Findings

Age (y)	Sex	CT findings	Lung biopsy	Lung pathology	Location of ¹⁸F-FDG uptake	SUVmax
64	F	Multiple nodules	Transthoracic needle	MALT lymphoma with plasmacytic differentiation, amyloid	Multiple nodules	5.2
78	F	Nodule with satellite nodularity	Surgical	MALT lymphoma with plasmacytic differentiation, amyloid	Single nodule	6.7
67	M	Multiple nodules, mediastinal and hilar adenopathy	Surgical	Nodular amyloid	Multiple nodules and intrathoracic lymph nodes	2.1
73	F	Multiple nodules, bronchiectasis	Surgical	MALT lymphoma with plasmacytic differentiation, amyloid	Single nodule	5.7
69	F	Interstitial/septal thickening, pleural mass	Bronchoscopic; transthoracic needle	Interstitial amyloid; plasmacytoma with amyloid	Pleural mass (plasmacytoma)	7.2
54	F	Multiple nodules	Surgical	Nodular amyloid	Single nodule	3.2
75	F	Multiple cysts, nodules	Bronchoscopic	Amyloid	Single nodule	2.6
75	M	Nodule	Surgical	MALT lymphoma with plasmacytic differentiation, amyloid	Single nodule	3.1