Clinical History
This is a 70-year-old male with lung carcinoma of the right lung. The study is to evaluate for metastatic disease.
Technique
The patient was given an IV injection of 10 mCi of fluorine-18 deoxyglucose and whole body PET imaging was obtained.
Findings
1. There is a large mass in the right mid lung demonstrating marked increased metabolic activity peripherally, measuring
approximately 8.0 cm in diameter. The standard uptake values measure 8.5 consistent with neoplastic metabolic activity.
2. There is a tail extending medially towards the hilum which also demonstrates activity of approximately 8.0 and is
consistent with neoplastic activity in right hilar lymph nodes. There is an area of increased metabolic activity identified at
the distal tip of the tumors tail in the superior right mediastinum pretracheal region which has standard uptake values of
approximately 1.9. This is in the inflammatory range of metabolic activity.
3. There is a second area of increased uptake in the inferior right mediastinum below the level of the mass on image
65/47/61 with an SUV of 2.5 which is intermediate between inflammatory and neoplastic metabolic activity.
4. There is normal activity identified in both kidneys. No abnormal activity is identified in the adrenal glands, liver, or other
abdominal viscera.
5. There is a linear area of increased uptake in the right paracentral mid abdomen consistent with activity within the mid to
distal right ureter.
Impressions
1. LARGE MASS IN THE RIGHT MID LUNG WITH MARKED ACTIVITY PERIPHERALLY CONSISTENT WITH
MALIGNANCY. THIS MASS DEMONSTRATES A TAIL OF INCREASED METABOLIC ACTIVITY EXTENDING TOWARD
THE RIGHT HILUM CONSISTENT WITH A LYMPH NODE WHICH ALSO DEMONSTRATES METABOLIC ACTIVITY IN
THE MALIGNANT RANGE.
2. THERE IS A SINGLE MEDIASTINAL LYMPH NODE INFERIOR TO THE MASS IN THE RIGHT MEDIASTINUM WITH
METABOLIC ACTIVITY WHICH IS INTERMEDIATE BETWEEN INFLAMMATORY AND NEOPLASTIC LEVELS.
3. NO EVIDENCE OF ABDOMINAL METASTATIC DISEASE.
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