Intensive FDG-PET/CT Uptake Suggestive of Malignancy Misleading the Diagnosis of Sclerosing Pneumocytoma

Abstract

 Introduction: Combined Positron Emission Tomography-Computed Tomography with 18-fluoro-desoxy-glucose (FDG-PET/CT) is highly sensitive in differentiating malignant from benign pulmonary lesions and is part of the current recommended practices for non-invasive lung nodule assessment. However, many solid pulmonary nodules may show misleading miscellaneous features and can be mistakenly diagnosed as malignant lesions.

Case Report: Herein we report the case of a passive smoking female patient with multiple comorbidities, who was referred for a solitary pulmonary nodule randomly discovered. Chest imaging showed a middle lobe 16-mm nodule with an intensive uptake (SUVmax 7.6) highly suggestive of malignant origin. The patient underwent middle lobectomy with radical lymphadenectomy because the malignancy was not excluded on frozen section. Definitive pathological examination showed a sclerosing pneumocytoma.

Conclusion: FDG-PET/CT is an accurate imaging tool for assessment of solid pulmonary nodules. However, false positive results of some benign lesions have to be kept in mind. Therefore, FDG-PET/CT features have to be interpreted according to the patients background and clinical data, in order to provide the best appropriate management.