Diagnosis to lung cancer after positive FDG PET scan: Pulmonary aspergilloma

Editorial - Research and Reports in Pulmonology (2021) Volume 2, Issue 2

Early diagnosis and treatment of lung cancer, one of the leading

causes of cancer-related death, is important to improve morbidity

and mortality. Therefore, any suspect solitary pulmonary nodule

should prompt the pursuit for a definitive histological diagnosis.

We describe the case of a 55-years-old male ex-smoker, who

was admitted to our hospital due to recurrent hemoptysis and dry

cough. A CT scan showed an irregular nodule of increasing size

(28 mm in diameter) in the left lower lobe (LLL). A whole-body

PET-CT scan was performed and confirmed an avid FDG uptake

of the nodule in the LLL, highly suspicious of lung cancer,

without any evidence of lymphogenic or hematogenic metastasis.

Bronchoscopy was not diagnostic and due to severe adhesions

after prior chest trauma and the central location of the nodule,

a lobectomy of the LLL was performed. Surprisingly, histology

showed a simple aspergilloma located in a circumscribed

bronchiectasis with no evidence of malignancy. This is a report

of an informative example of an aspergilloma, which presented

with symptoms and radiological features of malignant lung

cancer. Lung cancer is one of the leading causes of cancer-related

death for men and women in industrialized countries. Early

diagnosis and treatment are crucial to improve morbidity and

mortality. Positron emission tomography (PET) is a quantitative

molecular imaging technique that has significantly improved

diagnosis, staging and evaluation of treatment options for lung

cancer patients. Its sensitivity to detect pulmonary malignancies

is about 96%. Nevertheless, a variety of non-malignant, mainly

granulomatous, infectious, and inflammatory conditions can also

lead to an increased fluorodeoxyglucose (FDG) uptake and may

thus mimic lung cancer . Therefore, the reported specificity of

FDG PET is markedly lower, around 78%, than its sensitivity .

Thus, with the growing and more widespread usage of FDG PET

scans, an increasing number of less common, non-malignant, but

nevertheless PET positive findings, are getting detected. Here

we describe the case of a PET positive, irregular pulmonary

nodule turning out to be an aspergilloma. The patient was then

Author(s): Salah Alghanem