Pleomorphic carcinoma of the lung with intrapulmonary aerogenic metastases on FDG PET

A 59-year-old man presented with hemoptysis. Chest x-ray and computed tomography showed a cavitating mass and ground glass opacities in the right lower lobe. Positron emission tomography showed large regions of markedly increased fluorodeoxyglucose uptake in the right lower lobe consistent with primary cancer and intrapulmonary metastases, and several foci of high fluorodeoxyglucose uptake in the mediastinum and left neck consistent with lymph node metastases. We concluded that ground glass opacities were not aspiration of blood but intrapulmonary aerogenic metastases. Continuous active bleeding from the right bronchus (B6) was confirmed by bronchoscopy, and the right lower lobe was resected to remove the bleeding source. Pathologic findings showed pleomorphic carcinoma of the lung with intrapulmonary aerogenic metastases.