False positive diagnosis of malignancy in a case of cryptogenic organising pneumonia presenting as a pulmonary mass with mediastinal nodes detected on fluorodeoxyglucose-positron emission tomography: a case report.

Journal of Medical Case Reports
Aravind PonnuswamyJames P Finnerty

Abstract

We report the case of a patient with positive findings on a lung emission tomography/computed tomography (PET/CT) scan, with possible contra lateral mediastinal involvement, which strongly suggested an inoperable lung carcinoma. The lung mass proved to be a cryptogenic organising pneumonia. While the latter has previously been shown to be PET/CT positive, mediastinal involvement simulating malignant spread has not been previously reported. A 50-year-old Caucasian woman presented with a history of unproductive cough and was found to have a mass in the right upper lobe as shown on chest X-ray and a computed tomography scan. A subsequent PET/CT scan showed strong uptake in the right upper lobe (maximum standard uptake values (SUVmax) 9.6) with increased uptake in the adjacent mediastinum and contralateral mediastinal nodes. Surgical resection and mediastinoscopy revealed cryptogenic organising pneumonia, with enlarged reactive mediastinal lymph nodes. The case illustrates the limits of PET/CT scanning as a diagnostic tool, and emphasizes the importance of obtaining histological confirmation of malignant diseases whenever possible.

References

Mar 18, 2000·Thorax·J F Cordier
Nov 18, 2000·The Annals of Thoracic Surgery·P F RobertsD M Hopkins
Aug 18, 2004·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Robert J DowneyValerie Rusch
Mar 24, 2006·AJR. American Journal of Roentgenology·Carolina Althoff SouzaSemin Chong
Oct 6, 2007·Chest·Gerard A SilvestriUNKNOWN American College of Chest Physicians

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Citations

May 29, 2012·Journal of the Chinese Medical Association : JCMA·Wei-Yang LinShyh-Jen Wang
Jun 15, 2010·Clinical Radiology·C NanniS Fanti
Mar 9, 2018·Breathe·Charlotte Van de KerkhoveKris Nackaerts

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