A case of lung cancer associated with pneumoconiosis diagnosed by fluorine-18 fluorodeoxyglucose positron emission tomography

Detection of lung cancer in patients with pneumoconiosis by fluorodeoxyglucose-positron emission tomography/computed tomography: four cases

We report 4 cases of lung cancer in patients with pneumoconiosis detected by F18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), which could differentiate lung cancer and pneumoconiosis. FDG-PET/CT may be useful in cancer screening for patients with pneumoconiosis.

Clinical utility of FDG-PET and PET/CT in non-malignant thoracic disorders

There have been several endeavors made to investigate the potential role of 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography (FDG-PET) (and tracers) and PET-computed tomography imaging in various benign disorders, particularly those related to thoracic structures. These various conditions can be broadly categorized into three groups: (a) infectious diseases (mycobacterial, fungal, bacterial infection), (b) active granulomatous disease such as sarcoidosis, and (c) other non-infectious/inflammatory conditions or proliferative disorders (e.g., radiation pneumonitis, post-lung transplant lymphoproliferative disorders, occupational pleuropulmonary complications, and post-surgical conditions), all of which can demonstrate varying degrees of FDG uptake on PET scans based upon the degree of inflammatory activity. This article reviews the current state of this very important application of FDG-PET imaging.

Malignancy in kaolin pneumoconiosis found with F-18 FDG positron emission tomography

Kaolin pneumoconiosis may produce radiologic findings similar to those of malignancy. Current management includes serial radiologic examination and lung sampling of suspicious parenchymal opacities and nodules to exclude associated malignancy. This may result in unnecessary pulmonary resections in patients with already compromised lung function. In a patient with known kaolin pneumoconiosis and multiple nodules, we used positron emission tomography to identify suspicious areas for malignancy that were confirmed by open lung biopsy, leading to successful lung cancer treatment.

Focal parenchymal lung lesions showing a potential of false-positive and false-negative interpretations on integrated PET/CT

OBJECTIVE

We describe a number of benign focal lung lesions with increased 18F-FDG uptake that simulate lung cancer and malignant lesions that lead to false-negatives due to little 18F-FDG uptake on integrated PET/CT images.

CONCLUSION

The integration of clinical history, morphologic findings of lung parenchymal lesions on the CT component, and metabolic activities on the PET component of integrated PET/CT can help reduce false interpretation of the study. A lung biopsy may be needed for lesions showing increased 18F-FDG uptake on PET for tissue confirmation irrespective of their morphology on CT.

Pneumoconiosis associated with an esophageal ulcer and uptake revealed in FDGPET

A 76-year-old man with a past history of pneumoconiosis visited the Department of Gastroenterology in our hospital suffering from dysphagia. Gastroscopy revealed an esophageal ulcer on the top of a torus lesion. Chest computed tomography (CT) revealed it was caused by a swollen lymph node in the mediastinum. Squamous cell carcinoma related antigen (SCC) was elevated to 1.8 ng/ml. To rule out malignancy, we performed fluorine-18 deoxyglucose positron emission tomography (FDGPET) which revealed a significantly increased uptake in a nodular lesion in the right upper lobe and mediastinal lymph nodes. Biopsy and cytology of the nodular lesion revealed only pneumoconiosis. We must be careful when we interpret the findings of FDGPET in pneumoconiosis patients.