A case of septic pulmonary embolism associated with renal abscess mimicking pulmonary metastases of renal malignancy

Springer Science and Business Media LLC - Tập 28 - Trang 381-385 - 2014
Jo Sung Jung1, Sang Mi Lee2, Han Jo Kim3, Si-Hyong Jang4, Jeong Won Lee5
1Department of Radiology, Sooncheonhyang University Cheonan Hospital, Cheonan, Republic of Korea
2Department of Nuclear Medicine, Sooncheonhyang University Cheonan Hospital, Cheonan, Republic of Korea
3Department of Internal Medicine, Sooncheonhyang University Cheonan Hospital, Cheonan, Republic of Korea
4Department of Pathology, Sooncheonhyang University Cheonan Hospital, Cheonan, Republic of Korea
5Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

Tóm tắt

We report the case of a 46-year-old woman with acute febrile symptom who had multiple pulmonary nodules and a renal mass. She underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) to find a hidden malignancy and the cause of her fever. FDG PET/CT images demonstrated a renal mass and multiple lung nodules with intense FDG uptake, which was suspicious of a renal malignancy with multiple pulmonary metastatic lesions. CT-guided biopsies of the pulmonary and renal lesions only showed chronic inflammatory infiltrates without evidence of malignancy. She was diagnosed with septic pulmonary embolism from a renal abscess. One month after antibiotic treatment, the follow-up chest and abdomen CT showed improvement of the lung and renal lesions. This is the first case demonstrating the FDG PET/CT finding of septic pulmonary embolism associated with renal abscess in the published literature.

Tài liệu tham khảo

Jaffe RB, Koschmann EB. Septic pulmonary emboli. Radiology. 1970;96:527–32. Cook RJ, Ashton RW, Aughenbaugh GL, Ryu JH. Septic pulmonary embolism: presenting features and clinical course of 14 patients. Chest. 2005;128:162–6. Iwasaki Y, Nagata K, Nakanishi M, Natuhara A, Harada H, Kubota Y, et al. Spiral CT findings in septic pulmonary emboli. Eur J Radiol. 2001;37:190–4. Gunalp M, Gurler S, Polat O, Demirkan A. Septic pulmonary embolism associated with renal abscess: a case report. J Emerg Med. 2012;42:e51–3. MacMillan JC, Milstein SH, Samson PC. Clinical spectrum of septic pulmonary embolism and infarction. J Thorac Cardiovasc Surg. 1978;75:670–9. Sakuma M, Sugimura K, Nakamura M, Takahashi T, Kitamukai O, Yazu T, et al. Unusual pulmonary embolism: septic pulmonary embolism and amniotic fluid embolism. Cir J. 2007;71:772–5. Matsumoto H, Ishihara K, Fujii H, Hajiro T, Watanabe I, Nishimura T, et al. Computed tomographic findings in septic pulmonary emboli secondary to renal abscess. Nihon Kyobu Shikkan Gakkai Zasshi. 1996;34:937–42. Lee SJ, Cha SI, Kim CH, Park JY, Jung TH, Jeon KN, et al. Septic pulmonary embolism in Korea: Microbiology, clinicoradiologic features, and treatment outcome. J Infect. 2007;54:230–4. Meller J, Sahlmann CO, Scheel AK. 18F-FDG PET and PET/CT in fever of unknown origin. J Nucl Med. 2007;48:35–45. Gheysens O, Lips N, Adriaenssens T, Pans S, Maertens J, Herregods MC, et al. Septic pulmonary embolisms and metastatic infections from methicillin-resistant Staphylococcus aureus endocarditis on FDG PET/CT. Eur J Nucl Med Mol Imaging. 2012;39:183. Abikhzer G, Turpin S, Bigras JL. Infected pacemaker causing septic lung emboli detected on FDG PET/CT. J Nucl Cardiol. 2010;17:514–5. Suga K, Kawakami Y, Okada M, Iwanaga H, Matsunaga N. Lung morphology–perfusion correlation on perfusion SPECT–CT fusion images in two cases of septic pulmonary embolism. Clin Nucl Med. 2010;35:746–50.