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FDG-PET/CT finding of high uptake in pulmonary alveolar microlithiasis
Kimiteru Ito1, Kazuo Kubota, Masashi Yukihiro
1Department of Nuclear Medicine, International Medical Center of Japan, 1-21-1 Toyama, Tokyo 162-8655, Japan. itoukimiteru@yahoo.co.jp
Abstract:
Pulmonary alveolar microlithiasis (PAM) is a rare lung disease characterized by progressive intra-alveolar calcification. We present a case of PAM with abnormal accumulation of 18F-fluorodeoxyglucose (FDG) in both lungs. A 55-year-old man was referred to our hospital for progressive dyspnea. He had been diagnosed with PAM 25 years earlier by transbronchial lung biopsy. High-resolution computed tomography revealed multiple dense calcifications with little aerated lung. Combined positron emission tomography and computed tomography using 18F-FDG (FDG-PET/CT) showed the abnormal accumulation of FDG in both lungs with a maximal standardized uptake value of 7.3. High FDG uptake was observed mainly in the lung regions showing sparing calcification. The patient died of respiratory failure a month later and an autopsy revealed no significant inflammatory changes in either lung. We suspect that the markedly enhanced pulmonary FDG uptake may have some relation to the pathophysiology of PAM.
Insights
Pulmonary alveolar microlithiasis (PAM) involves lung calcification. This rare disease showed abnormal 18F-fluorodeoxyglucose (FDG) accumulation in the lungs, potentially linked to its underlying causes.
Area of Science:
- Pulmonology
- Nuclear Medicine
- Radiology
Background:
- Pulmonary alveolar microlithiasis (PAM) is a rare interstitial lung disease.
- Characterized by diffuse intra-alveolar accumulation of calcified particles.
- Often presents with progressive dyspnea and diffuse lung opacities.
Observation:
- A 55-year-old male with a 25-year history of PAM presented with worsening dyspnea.
- High-resolution CT showed extensive calcifications with minimal aeration.
- FDG-PET/CT revealed significant abnormal 18F-fluorodeoxyglucose uptake in both lungs.
Findings:
- Maximal standardized uptake value (SUVmax) of 7.3 for FDG.
- Elevated FDG uptake was predominantly noted in lung regions spared from calcification.
- Autopsy showed no significant inflammatory changes, despite high FDG uptake.
Implications:
- Suggests a potential link between enhanced pulmonary FDG uptake and PAM pathophysiology.
- Highlights the utility of FDG-PET/CT in evaluating rare lung diseases.
- Warrants further investigation into metabolic changes in PAM.
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