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This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fox, B D Articles by Kramer, M R Search for Related Content PubMed PubMed Citation Articles by Fox, B D Articles by Kramer, M R Topic Collections Thorax Images in Thorax

A "fat chance" it’s malignant: lipoid pneumonia simulating lung cancer on PET scan

Pulmonary Institute Rabin Medical Center, Petah Tiqva, Israel

Correspondence to:
Correspondence to:
Professor M R Kramer
Pulmonary Institute Beilinson Campus, Rabin Medical Center, Petah Tiqva 49100, Israel; kramerm{at}netvision.net.il

A 65-year-old man underwent lobectomy following a positron emission tomography (PET) scan showing increased uptake in a nodular lesion in the middle lobe (fig 1). A preoperative transbronchial biopsy specimen demonstrated lipoid pneumonia which was disregarded as a false positive (fig 2). No tumour was seen in the excised lobe.

View larger version (39K): [in this window] [in a new window] [PowerPoint for Teaching]   Figure 1  Fluorodeoxyglucose positron emission tomography (PET) fusion CT scan showing moderately increased uptake in the middle lobe nodule (at the crossing point of the red lines). On CT scanning the lesion is approximately –50 Hounsfield units, consistent with fat.

View larger version (144K): [in this window] [in a new window] [PowerPoint for Teaching]   Figure 2  Transbronchial biopsy specimen showing alveolar inflammation, predominantly macrophages. Vacuoles are present within the alveoli and macrophages representing lipid material (black arrowheads). Giant cells also contain lipid (large black arrows). H&E stain; x200 magnification.

Learning points Lipoid pneumonia may take a variety of forms, including mass lesions. The history of oil ingestion is frequently not elicited until after the pathological diagnosis is made. Inflammatory lung lesions may show increased uptake on PET scanning. If a lung biopsy shows lipoid pneumonia in a PET-positive lesion, a conservative approach may be warranted.

 

FOOTNOTES
Funding: None.

Competing interests: None.

References

1. Laurent F, Philippe J C, Vergier B, et al. Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings. Eur Radiol 1999;9:1190–6.[CrossRef][Medline]
2. Abouzied M M, Crawford E S, Nabi H A. 18F-FDG imaging: pitfalls and artifacts. J Nucl Med Technol 2005;33:145–55.[Abstract/Free Full Text]

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fox, B D Articles by Kramer, M R Search for Related Content PubMed PubMed Citation Articles by Fox, B D Articles by Kramer, M R Topic Collections Thorax Images in Thorax