PET/CT Findings of Granulomatosis With Polyangiitis Presenting as a Solitary Pulmonary Nodule and Mimicking Lung Cancer

Gorospe, Luis; Ajuria-Illarramendi, Odile; Puente-Bujidos, Carlos de la; Muñoz-Molina, Gemma María; Cabañero-Sánchez, Alberto; Moreno-Mata, Nicolás; Benito-Berlinches, Amparo

doi:10.1097/rhu.0000000000000994

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…The more solid the components in ground-glass nodules, the worse the prognosis [ 32 ]. Calcification foci in SPN are mostly benign, suggesting that calcification is mostly caused by healing of old lesions and belongs to stable lesions [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Application of CT Postprocessing Reconstruction Technique in Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodules and Analysis of Risk Factors

Chen

2022

Computational and Mathematical Methods in Medicine

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Objective. To evaluate the application of CT postprocessing reconstruction technique in differential diagnosis of benign and malignant solitary pulmonary nodules and analysis of risk factors. Methods. A total of 150 solitary pulmonary nodules (SPN) patients admitted to our hospital from January 2020 to January 2022 were selected and divided into the benign SPN group ( n = 64 ) and the malignant SPN group ( n = 86 ) according to pathological results. All subjects underwent CT plain scan and CT postprocessing reconstruction, and the general information of the subjects was collected. The diagnostic value of CT plain scan and CT postprocessing reconstruction techniques for benign and malignant SPN was compared; and the CT signs of benign and malignant SPN were compared, and the risk factors of malignant SPN were analyzed. Results. The pathological results of this study showed that there were 64 cases with benign SPN and 86 cases with malignant SPN. The sensitivity, specificity, accuracy, positive predictive rate, and negative predictive rate of CT postprocessing reconstruction technology in diagnosing malignant SPN were 73.44%, 89.53%, 82.67%, 83.39%, and 81.91%, respectively, which were higher than 56.25%, 65.12%, 61.33%, 54.55%, and 66.67% of CT plain scan, and the difference was statistically significant ( P < 0.05 ). There were no significant differences in nodule location, nodule density, vacuole sign, vessel convergence, and pleural depression sign between the two groups ( P > 0.05 ). There were statistically significant differences in age, nodule diameter, lobulation sign, burr sign, calcification components, and ground-glass components between the two groups ( P < 0.05 ). Multivariate analysis showed that age ≥ 60 years, nodule diameter ≥ 15 mm , the presence of lobulation sign, burr sign, ground-glass components, and noncalcification components were independent risk factors for malignant SPN. Conclusion. CT postprocessing reconstruction technique has high diagnostic value in the differentiation of benign and malignant SPN, age ≥ 60 years , nodule diameter ≥ 15 mm , lobulation signs, burr signs, ground-glass components, and noncalcification components are independent risk factors for malignant SPN.

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Section: Discussionmentioning

confidence: 99%

Application of CT Postprocessing Reconstruction Technique in Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodules and Analysis of Risk Factors

Chen

2022

Computational and Mathematical Methods in Medicine

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“…Nodules can vary anywhere from 3 mm to over 30 mm and from solid to cavitating. These are often hypermetabolic on 18F-fluorodeoxyglucose PET/CT, making it difficult to differentiate between malignancy, pneumonia or noninfectious inflammatory conditions [6, 12, 13].…”

Section: Discussionmentioning

confidence: 99%

Solitary Pulmonary Nodule: A Diagnostic Dilemma

Masuta

Amzuta

2019

Case Reports in Pulmonology

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This case describes a woman with a history of tobacco abuse who presented with a dry cough and was found to have an enlarging, 4 cm right upper lobe nodule without lymphadenopathy on CT imaging of the chest. Initial biopsies of the nodule suggested follicular lymphoma, but after obtaining more tissue, the pathology was negative for malignancy and instead showed necrotizing pneumonia. She proceeded to have negative infectious serology and cultures. She had negative rheumatological testing including MPO ANCA, PR-3 ANCA, and rheumatoid factor. She did not have renal failure, hemoptysis, weight loss, arthralgia, or upper airway inflammation. She ultimately underwent a right upper lobectomy, as the nodule was enlarging on repeat imaging. The pathology of the lung showed necrotizing granulomas with giant cells and fibrosis, but lacked active vasculitis or palisading histiocytes, further obscuring the diagnosis. She was conservatively managed with intranasal steroids, cough suppressants and antihistamines given her lack of severe symptoms. The diagnosis was most consistent with granulomatosis with polyangiitis (GPA) presenting as a solitary pulmonary nodule with pathology reflecting a mild degree of disease activity. The patient may manifest further signs of the disease while being monitored clinically.

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