Case Author(s): David A. Hillier, M.D., Ph.D. and Farroqh Dehdashti, M.D. , . Rating: #D2, #Q3
61 year-old man with left pleural thickening.
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Full history/Diagnosis is available below
61 year-old man with left mesothelioma. Evaluate extent of disease.
15 mCi fluorodeoxyglucose, IV
1. FDG PET:
- Intense activity in pleura of left hemithorax. The extent
of disease was better defined by FDG-PET, when the PET results compared
with histopathological findings.
2. Follow up chest radiograph (3 weeks later):
- Status post pneumonectomy.
PET can be used to diagnose malignant mesothelioma and define
the extent of disease. Computed tomography cannot be used to
definitively distinguish malignant mesothelioma from benign diffuse
In a report by Bénard et al, FDG-PET was shown to be useful in differentiating
malignant mesothelioma (24/28) from benign pleural lesions (4/28). The
FDG uptake was significantly higher in malignant than benign lesions
(mean SUV = 4.9 ± 2.9 and 1.4 ± 0.6, respectively; p<0.0001). In
addition the extent of disease can be more reliably determined on
FDG-PET compared with CT. Lymph node involvement was noted on FDG-PET
in 12 patients, 9 of which appeared normal on CT.
1. Baas P and Zoetmulder FAN. Malignant pleural mesothelioma.
Ann Oncol 1998; 9:139-149.
2. Bénard, François, et al. Metabolic imaging of malignant pleural
mesothelioma with fluorodeoxyglucose positron emission tomography.
Chest 1998; 114:713-722.
The patient underwent pneumonectomy.
ACR Codes and Keywords:
References and General Discussion of PET Tumor Imaging Studies (Anatomic field:Lung, Mediastinum, and Pleura, Category:Neoplasm, Neoplastic-like condition)
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Case number: pt026
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