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CT with Histopathologic Correlation of FDG Uptake in a Patient with Pulmonary Granuloma and Pleural Plaque Caused by Remote Talc Pleurodesis

Minh Nguyen1, Vijay Varma2, Rafael Perez3 and David M. Schuster4

1 Department of Radiology, Division of Nuclear Medicine, Atlanta VAMC, 1670 Clairmont Rd., Decatur, GA 30033.
2 Department of Pathology, Atlanta VAMC, Decatur, GA 30033.
3 Department of Pulmonary, Allergy, and Critical Care Medicine, Atlanta VAMC, Decatur, GA 30033.
4 Department of Radiology, Division of Nuclear Medicine, Emory University Hospital, 1364 Clifton Rd., NE, Atlanta, GA 30322.



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  		Fig. 1A. —53-year-old man with history of talc pleurodesis and right pulmonary nodules. CT scan shows partially calcified pulmonary nodule (arrow) in posterior segment of right upper lobe adjacent to fissure.

 


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  		Fig. 1B. —53-year-old man with history of talc pleurodesis and right pulmonary nodules. FDG positron emission tomography (PET) image shows increased metabolic activity (arrow) at location of pulmonary nodule seen in A.

 


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  		Fig. 1C. —53-year-old man with history of talc pleurodesis and right pulmonary nodules. CT scan shows high-attenuation pleural plaque (arrow) in right posterior costophrenic sulcus.

 


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  		Fig. 1D. —53-year-old man with history of talc pleurodesis and right pulmonary nodules. FDG PET image shows increased metabolic activity (arrow) at location of pleural plaque seen in C.

 


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  		Fig. 1E. —53-year-old man with history of talc pleurodesis and right pulmonary nodules. Photomicrograph of histopathologic specimen shows granuloma composed of numerous multinucleated giant cells (arrow) admixed with lymphocytes. Note intracellular material. (H and E, x400)

 


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  		Fig. 1F. —53-year-old man with history of talc pleurodesis and right pulmonary nodules. Photomicrograph of histopathologic specimen from E under polarized light shows intracellular birefringent crystals (arrow), characteristic of talc granuloma. (H and E, x100)

 

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