Research and Reports in Pulmonology

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

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


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

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