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Case Reports
. 2022 Jan 14;17(3):907-910.
doi: 10.1016/j.radcr.2021.11.049. eCollection 2022 Mar.

Steroid responsive inflammatory myofibroblastic tumor of the lung evaluated by FDG PET/CT imaging

James Yuheng Jiang  1 , Monica Comsa  2   3 , Veronica Chi Ken Wong  1   3 , Robert Mansberg  1   3
Affiliations
Case Reports

Steroid responsive inflammatory myofibroblastic tumor of the lung evaluated by FDG PET/CT imaging

James Yuheng Jiang et al. Radiol Case Rep. .

Abstract

A 68-year-old gentleman was referred for 18F-FDG PET/CT for a pulmonary mass in the left upper lobe which demonstrated intensely FDG-avid confluent pulmonary consolidation in the left upper lobe (SUVmax 15.1). Histopathologic biopsy of the left upper lobe lung mass was consistent with inflammatory myofibroblastic tumor (IMT). The patient was started on steroid treatment in conjunction with antibiotics. Follow-up FDG PET/CT 3 weeks after commence of treatment showed remarkable response of the IMTs to therapy with much less avid FDG uptake (SUVmax 5.4) and marked improvement in the pulmonary consolidation. Nevertheless, the patient underwent left upper lobe lobectomy due to evidence of persistent cystic disease and malignant potential associated with IMTs. Final histopathology was consistent with IMT with no evidence of malignancy.

Keywords: FDG; PET; inflammatory myofibroblastic tumor; inflammatory pseudotumor.

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Figures

Fig 1
Fig. 1
(A) Maximal intensity projection (MIP), (B) axial 18F-FDG PET and (C) axial CT of a 68-year-old-gentleman referred for a pulmonary mass in the left upper lobe demonstrates intensely avid confluent pulmonary consolidation in the left upper lobe (SUVmax 15.1) with mild to moderate uptake in left lower paratracheal lymph node (SUVmax 3.6), and in aortopulmonary window lymph nodes.
Fig 2
Fig. 2
(A) MIP, (B) axial 18F-FDG PET, and (C) axial CT 3 weeks after initiation of steroid and antibiotics demonstrates significant metabolic response (SUVmax 5.1) and near complete resolution of consolidative changes with residual cystic changes and bronchiectasis in the left upper lobe. Previously FDG-avid lymph nodes are no longer evident. No new sites of FDG avid disease was demonstrated.
Fig 3
Fig. 3
Axial CT chest 4 weeks later shows complete resolution of consolidation and further improvement in the irregular opacities in the left upper lobe. There is however, residual left upper lobe fibrosis, bronchiectasis and cystic changes.
See this image and copyright information in PMC

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