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FDG PET of Pleural Effusions in Patients with Non—Small Cell Lung Cancer

Jeremy J. Erasmus1, H. Page McAdams, Santiago E. Rossi, Philip C. Goodman, R. Edward Coleman and Edward F. Patz

1 All authors: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.



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  		Fig. 1A. —73-year-old man with non—small cell cancer and large left-sided pleural effusion. CT scan shows large left-sided pleural effusion and reveals diffuse and nodular thickening of left visceral (arrowheads) and parietal pleura, respectively. Note enlarged paracardiac and paraesophageal nodes (arrows).

 


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  		Fig. 1B. —73-year-old man with non—small cell cancer and large left-sided pleural effusion. Axial positron emission tomographic image with 18F-fluorodeoxyglucose shows marked increased uptake in visceral and parietal pleura (arrowheads). Note increased mediastinal nodal uptake (arrows) suggestive of metastases. L = liver, V = vertebral body.

 


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  		Fig. 2A. —65-year-old man with non—small cell cancer who presented with dyspnea and large left-sided pleural effusion. Cytologic evaluation of pleural fluid obtained by thoracentesis revealed negative findings for malignancy. CT scan shows large left-sided pleural effusion. Note lack of focal or diffuse pleural thickening, either of which would be suggestive of metastases. E = pleural effusion.

 


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  		Fig. 2B. —65-year-old man with non—small cell cancer who presented with dyspnea and large left-sided pleural effusion. Cytologic evaluation of pleural fluid obtained by thoracentesis revealed negative findings for malignancy. Axial positron emission tomographic image with 18F-fluorodeoxyglucose shows focal increased uptake in parietal pleura (arrowheads). Note effusion (asterisks). H = heart with normal uptake in myocardium, L = liver, V = vertebral body.

 


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  		Fig. 2C. —65-year-old man with non—small cell cancer who presented with dyspnea and large left-sided pleural effusion. Cytologic evaluation of pleural fluid obtained by thoracentesis revealed negative findings for malignancy. CT scan obtained 4 months after left-sided pneumonectomy shows recurrent malignancy surrounding surgical sutures (arrowheads). Note lobular pleural thickening suggestive of pleural metastases (arrows).

 


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  		Fig. 3A. —73-year-old man with non—small cell cancer in left lung (not shown) who presented with pulmonary edema and bilateral pleural effusions. CT scan shows medium right-sided and large left-sided pleural effusions. Note lack of focal or diffuse pleural thickening, either of which would be suggestive of metastases. Also note focal pleural calcification (arrow) caused by prior trauma.

 


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  		Fig. 3B. —73-year-old man with non—small cell cancer in left lung (not shown) who presented with pulmonary edema and bilateral pleural effusions. Axial positron emission tomographic image with 18F-fluorodeoxyglucose (FDG) shows normal mediastinal and cardiac activity without increased FDG uptake in pleura. After thoracentesis of left-sided effusion, cytologic evaluation revealed negative findings for malignant cells. Both effusions resolved after patient's cardiac failure was treated with diuretic therapy. H = heart with normal uptake in myocardium, M = mediastinum, V = vertebral body.

 

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