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The Evaluation of FDG PET/CT Scan Findings in Patients with Organizing Pneumonia Mimicking Lung Cancer.

Erdoğan Y, Özyürek BA, Özmen Ö, Yılmaz Demirci N, Duyar SŞ, Dadalı Y, Demirağ F, Karakaya J - Mol Imaging Radionucl Ther (2015)

Bottom Line: OP may cause false positive results on PET/CT.However, PET/CT results may be used as a guide for invasive procedures that should be performed when there is suspicion of malignancy.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Beypazarı State Hospital, Clinic of Pulmonology, Ankara, Turkey Phone: +90 505 297 53 27 E-mail: drsezgisahin@gmail.com.

ABSTRACT

Objective: Organizing pneumonia (OP) is a rare lung condition that is characterized by the presence of polypoid tissues due to fibroblastic plugs within respiratory bronchioles, alveolar ducts and sacs. The three main radiologic patterns of OP include typical, solitary-focal and infiltrative forms. The maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET/CT) may be high in benign conditions such as OP as well as malignant diseases. The aim of our study was to investigate PET-CT characteristics of OP in patients mimicking lung cancer.

Methods: The clinical and radiologic characteristics of 50 patients who were referred to our hospital for PET/CT evaluation due to suspicion of lung malignancy, and who were pathologically diagnosed as OP between 2009 and 2013 were retrospectively reviewed.

Results: The mean age of the patients was 58.2 years. Ninety-six percent of patients (48) were male. Radiologic evaluation revealed 27 (54%) focal involvement, 10 (20%) consolidation with air-bronchogram (typical), 1 (2%) infiltrative and 12 (24%) other types of involvement (multiple nodules and cavitary lesions). The mean SUVmax value of the lesions on PET/CT was calculated as 6.5. Mediastinal lymph node involvement (at least one station) was detected in 76% of our study group with a mean SUVmax value of 3.27.

Conclusion: OP may cause false positive results on PET/CT. However, PET/CT results may be used as a guide for invasive procedures that should be performed when there is suspicion of malignancy.

No MeSH data available.


Related in: MedlinePlus

CT and PET-CT scans of a patient with mediastinal massA) A mediastinal lesion of 6.2x4x5 in size, extending to the paramediastinal area from the apical region of the left lung on Thorax CT. B) SUVmax of the lesion on PET/CT was 10.59. The center of the mass was hypo-metabolic. C) High metabolic activity in subcarinal (SUVmax: 6.96), right hilar (SUVmax: 3.32-4.07) and left hilar (SUVmax: 4.12) mediastinal lymph nodes. The pathology of the specimen obtained via trans-thoracic fine needle aspiration biopsy revealed organizing pneumonia
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f3: CT and PET-CT scans of a patient with mediastinal massA) A mediastinal lesion of 6.2x4x5 in size, extending to the paramediastinal area from the apical region of the left lung on Thorax CT. B) SUVmax of the lesion on PET/CT was 10.59. The center of the mass was hypo-metabolic. C) High metabolic activity in subcarinal (SUVmax: 6.96), right hilar (SUVmax: 3.32-4.07) and left hilar (SUVmax: 4.12) mediastinal lymph nodes. The pathology of the specimen obtained via trans-thoracic fine needle aspiration biopsy revealed organizing pneumonia

Mentions: Radiologic findings included focal involvement, consolidation with air-bronchogram (typical), infiltrative, and other types of involvement (multiple nodules and cavitary lesions). Focal lesions consisted of 12 cavitary lesions, 3 ground glass opacities, and 12 solid masses (Figure 1-3). The other radiologic manifestations in our study were multiple cavitary nodules seen in 1 patient, and multiple solid nodules in 11 patients (Figure 2) (Table 1). The mean SUVmax values of radiologic subtypes (typical, focal and the others) were statistically similar (p=0.142) (Table 2). The mean diameter of the primary lesion was 37.7 mm. The mean SUVmax value of the lesions on PET/CT was calculated as 6.5. Mediastinal lymph node involvement (at least one station) was detected in 38 patients (76%). High SUVmax values (SUVmax>2) were observed in N1, N2 and N3 lymph nodes in 37, 30 and 2 patients, respectively. The ratio of N1 and N2 lymph node involvement in different radiologic subtypes did not show a statistically significant difference (Table 3). The mean SUVmax value of these lymph nodes was 3.27.


The Evaluation of FDG PET/CT Scan Findings in Patients with Organizing Pneumonia Mimicking Lung Cancer.

Erdoğan Y, Özyürek BA, Özmen Ö, Yılmaz Demirci N, Duyar SŞ, Dadalı Y, Demirağ F, Karakaya J - Mol Imaging Radionucl Ther (2015)

CT and PET-CT scans of a patient with mediastinal massA) A mediastinal lesion of 6.2x4x5 in size, extending to the paramediastinal area from the apical region of the left lung on Thorax CT. B) SUVmax of the lesion on PET/CT was 10.59. The center of the mass was hypo-metabolic. C) High metabolic activity in subcarinal (SUVmax: 6.96), right hilar (SUVmax: 3.32-4.07) and left hilar (SUVmax: 4.12) mediastinal lymph nodes. The pathology of the specimen obtained via trans-thoracic fine needle aspiration biopsy revealed organizing pneumonia
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563171&req=5

f3: CT and PET-CT scans of a patient with mediastinal massA) A mediastinal lesion of 6.2x4x5 in size, extending to the paramediastinal area from the apical region of the left lung on Thorax CT. B) SUVmax of the lesion on PET/CT was 10.59. The center of the mass was hypo-metabolic. C) High metabolic activity in subcarinal (SUVmax: 6.96), right hilar (SUVmax: 3.32-4.07) and left hilar (SUVmax: 4.12) mediastinal lymph nodes. The pathology of the specimen obtained via trans-thoracic fine needle aspiration biopsy revealed organizing pneumonia
Mentions: Radiologic findings included focal involvement, consolidation with air-bronchogram (typical), infiltrative, and other types of involvement (multiple nodules and cavitary lesions). Focal lesions consisted of 12 cavitary lesions, 3 ground glass opacities, and 12 solid masses (Figure 1-3). The other radiologic manifestations in our study were multiple cavitary nodules seen in 1 patient, and multiple solid nodules in 11 patients (Figure 2) (Table 1). The mean SUVmax values of radiologic subtypes (typical, focal and the others) were statistically similar (p=0.142) (Table 2). The mean diameter of the primary lesion was 37.7 mm. The mean SUVmax value of the lesions on PET/CT was calculated as 6.5. Mediastinal lymph node involvement (at least one station) was detected in 38 patients (76%). High SUVmax values (SUVmax>2) were observed in N1, N2 and N3 lymph nodes in 37, 30 and 2 patients, respectively. The ratio of N1 and N2 lymph node involvement in different radiologic subtypes did not show a statistically significant difference (Table 3). The mean SUVmax value of these lymph nodes was 3.27.

Bottom Line: OP may cause false positive results on PET/CT.However, PET/CT results may be used as a guide for invasive procedures that should be performed when there is suspicion of malignancy.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Beypazarı State Hospital, Clinic of Pulmonology, Ankara, Turkey Phone: +90 505 297 53 27 E-mail: drsezgisahin@gmail.com.

ABSTRACT

Objective: Organizing pneumonia (OP) is a rare lung condition that is characterized by the presence of polypoid tissues due to fibroblastic plugs within respiratory bronchioles, alveolar ducts and sacs. The three main radiologic patterns of OP include typical, solitary-focal and infiltrative forms. The maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET/CT) may be high in benign conditions such as OP as well as malignant diseases. The aim of our study was to investigate PET-CT characteristics of OP in patients mimicking lung cancer.

Methods: The clinical and radiologic characteristics of 50 patients who were referred to our hospital for PET/CT evaluation due to suspicion of lung malignancy, and who were pathologically diagnosed as OP between 2009 and 2013 were retrospectively reviewed.

Results: The mean age of the patients was 58.2 years. Ninety-six percent of patients (48) were male. Radiologic evaluation revealed 27 (54%) focal involvement, 10 (20%) consolidation with air-bronchogram (typical), 1 (2%) infiltrative and 12 (24%) other types of involvement (multiple nodules and cavitary lesions). The mean SUVmax value of the lesions on PET/CT was calculated as 6.5. Mediastinal lymph node involvement (at least one station) was detected in 76% of our study group with a mean SUVmax value of 3.27.

Conclusion: OP may cause false positive results on PET/CT. However, PET/CT results may be used as a guide for invasive procedures that should be performed when there is suspicion of malignancy.

No MeSH data available.


Related in: MedlinePlus