Pitfalls in interpretation of FDG PET/CT: Septic pulmonary emboli mimicking metastases in a case of gastric carcinoma
| Autor: | Prateek Kinra, Aftab Alam, Brijesh K Soni, Harkirat Singh, T V S V G K Tilak |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty 040301 veterinary sciences medicine.medical_treatment R895-920 central venous catheter 0403 veterinary science Medical physics. Medical radiology. Nuclear medicine 03 medical and health sciences septic pulmonary emboli medicine Radiology Nuclear Medicine and imaging Blood culture Stomach cancer Chemotherapy Lung medicine.diagnostic_test business.industry 04 agricultural and veterinary sciences Thorax 030108 mycology & parasitology medicine.disease Catheter medicine.anatomical_structure Positron emission tomography Chills Radiology medicine.symptom fdg pet/ct business Central venous catheter |
| Zdroj: | Indian Journal of Radiology and Imaging, Vol 26, Iss 04, Pp 524-527 (2016) The Indian Journal of Radiology & Imaging |
| ISSN: | 1998-3808 0971-3026 |
| DOI: | 10.4103/0971-3026.195792 |
| Popis: | Inflammatory lesions may sometimes show intense tracer uptake and mimic neoplastic lesions on (18) F-fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). We report one such false positive case on FDG PET/CT, where septic pulmonary emboli (SPE) mimicked pulmonary metastases. A 45-year-old man with stomach cancer had an indwelling central venous catheter (CVC) in situ while on neoadjuvant chemotherapy. He underwent FDG PET/CT scan for response assessment and the images revealed multiple, intensely FDG avid, peripheral, lung nodules with feeding vessels, which were suspicious for pulmonary metastases. A day later, the patient developed fever with chills and his blood culture showed bacterial growth (Enterobacter cloacae). A provisional diagnosis of SPE from an infected CVC was made. Chemotherapy was withheld, CVC removed, and the catheter tip was sent for bacterial culture. Following a 4-week course of antibiotic treatment, the patient became afebrile. Culture from the CVC tip grew the same organism, as was seen earlier in the patient's blood culture, thus pin-pointing the source of infection in our case. Diagnosis of SPE was clinched when follow-up CT chest done after completion of antibiotic course showed complete resolution of the lung lesions. |
| Databáze: | OpenAIRE |
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