YENİ Serpil AKTEN, Can ÖZTÜRK, Ahmet Selim YURDAKUL, Ayhan VAROL

Pnömokonyozlu hastalarda malign hastalığı taklit eden yanlış pozitif 18F-FDG PET/BT bulguları (üç olgu nedeniyle)

Kömür madenciliğinde bilinen pnömokonyoz ve kronik obstrüktif akciğer hastalığı riskleri yanında özellikle silika ve diğer karsinojenlere maruziyete bağlı olarak potansiyel akciğer kanseri riski de söz konusudur. Kliniğimize hemoptiziyle başvu- ran ve dış merkezde çekilen akciğer bilgisayarlı tomografiler (BT)’indeki farklı natürde kitle görünümleri nedeniyle kömür işçisi pnömokonyozu ve akciğer kanseri ön tanısıyla yönlendirilen olgular ileri tetkik ve tedavi amacıyla yatırıldı. Rutin tet- kikler, balgam aside dirençli basil ve balgam sitoloji sonuçları normal olarak değerlendirilen hastadan malignite ayırımı açı- sından pozitron emisyon tomografisi (PET) istendi. Olguların PET/BT’lerinde toraks tomografilerindeki farklı natürdeki kit- le görünümlerinde patolojik düzeyde 18F-FDG tutulumları tespit edildi. Malignite ayırımı açısından fiberoptik bronkosko- pik biyopsi ve/veya mediastinoskopi yapılan olgulardan alınan patolojik materyallerin tümünün incelemesi benign olarak geldi. Kliniğimize başvuran yanlış pozitif PET/BT bulguları olan üç pnömokonyoz tanılı olguyu literatür eşliğinde sunmayı amaçladık. Sonuç olarak, PET/BT’de yanlış pozitif durumlar arasında pnömokonyozların da akılda tutulmasının gerektiği- ni düşünmekteyiz.

False positive 18F-FDG PET/CT findings mimicking malignant disease in patients with pneumoconiosis (due to three case reports)

Besides the risk of developing pneumoconiosis and chronic obstructive pulmonary disease, potential lung cancer risk may also increase due to exposure to silica and other carcinogens. Patients with hemoptysis symptom referred to our clinic de- pending on different forms of mass images in their thorax computerize tomography (CT) scan with the suspicion of coal- worker pneumoconiosis and lung cancer were hospitalized for investigation and treatment. The results of routine tests, spu- tum acid-fast bacilli and sputum cytology were evaluated as normal. PET/CT was ordered from patients for identifying ma- lignancy. In PET/CTs of the patients, a pathological level of 18F fluorodeoxyglucose uptake was identified in different forms of mass images observed previously in thorax CTs. All the pathological specimens obtained by fiberoptic bronchoscopic bi- opsy and/or by mediastinoscopy were reported as benign. We aimed to present three pneumoconiosis patients with false positive PET/CT findings in the light of relevant literature. As a result, we thought that pneumoconiosis must be in mind also when considering about false positive results of PET/CT.

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