Tseng Ting-Chun, Chan Hung-Pin, Shen Daniel Hueng-Yuan, Lin Chang-Chung
Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan.
Diagnostics (Basel). 2024 Dec 27;15(1):41. doi: 10.3390/diagnostics15010041.
We report a case of a 73-year-old man with minimally invasive lung adenocarcinoma, post-resection, evaluated with F-FDG PET/CT for suspected disease progression. Imaging showed increased FDG uptake in the right lower lung mass and systemic lymphadenopathy (mediastinal, supraclavicular, axillary, paraaortic, and iliac regions). The appearance of a stable lymph node and a clinical history of IgG4 lymphadenopathy suggested an inflammatory process, although malignancy in the lung mass and mediastinal nodes could not be excluded. Lobectomy confirmed the presence of lung adenocarcinoma, while radical lymph node dissection identified IgG4-related lymphadenopathy without metastasis. This case underscores the need for considering differential diagnosis of PET-positive lymphadenopathy, especially in patients with comorbid conditions that mimic or coexist with malignancy.
我们报告一例73岁男性，患有微创肺腺癌，术后因怀疑疾病进展接受F-FDG PET/CT评估。影像显示右下肺肿块及全身淋巴结肿大（纵隔、锁骨上、腋窝、腹主动脉旁和髂区）处FDG摄取增加。尽管不能排除肺部肿块和纵隔淋巴结存在恶性肿瘤，但一个稳定的淋巴结表现及IgG4相关性淋巴结病的临床病史提示为炎症过程。肺叶切除术证实存在肺腺癌，而根治性淋巴结清扫术发现为IgG4相关性淋巴结病，无转移。该病例强调了对PET阳性淋巴结病进行鉴别诊断的必要性，尤其是在伴有模拟恶性肿瘤或与恶性肿瘤共存的合并症患者中。
