Lung cancer

Case contributed by Mostafa El-Feky

Presentation

Hemoptysis

Patient Data

Age: 60 years
Gender: Male

At presentation

ct

Diffuse centrilobular emphysema.

Left upper lobe mass lesion at the medial aspect of its anterior segment, with irregular spiculated margins. It reaches the medial pleural surface near the aortic arch with a thin fat plane inbetween. It is amputating the anterior subsegmental divisions of the left upper lobe and lingula bronchi. It is measuring 4.5 x 4.7 cm axial dimensions. There is associated thickening of left oblique fissure and thick superior pleural tag. It is inseparable from the left pulmonary artery and bronchi.

Follow up after 6 months on chemotherapy

ct

No significant changes are seen as regards the size of the lesion.

Progressive increased thickness and nodularity of left oblique fissure as well as the related medial pleural surface and decreased inflation of lingula secondary to progressive bronchial obstruction by the mass. 

PET/CT

Nuclear medicine

PET/CT is done after one hour of IV injection of 300 MBq of 18-F-FDG.

Glucose avid soft tissue mass lesion is noted at the apico-posterior segment of left upper lobe with spiculated outer borders, merging the left hilar lymph nodes and compressing left main bronchus. It shows central with denser tracer fixation at the periphery with SUV max of 10.

Case Discussion

This is a known case of lung cancer on chemotherapy. No metastasis detected.

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