PMC9253644_01
PA chest radiograph was normal on initial presentation (A). Axial CT chest from PET-CT shows two FDG-avid ground glass nodules in the right upper lobe (B,C).
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Chest CT showed a ground glass nodule (GGN) measuring 1.0 cm and another one measuring 0.6 cm in the S1 of the right lung (Fig. 1). We considered a probable diagnosis of Synchronous primary lung cancers with cT1aN0M0 stage IA1 (Fig. 1).
Bronchial running as seen on 3D-CT (A). The bronchial running as demonstrated by bronchoscopy (B, C).
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Therefore, we performed bronchoscopy, which revealed a branching right B1 in the upper lobe and branching B2+3 from the lateral side of the middle lobar bronchus of the right truncus intermedius (Fig. 2).
PMC9253644_02
PA chest radiograph on initial presentation depicts a irregular mass-like opacity in the central right midlung (A). Axial CT chest shows a large mass-like opacity in the right upper lobe (B). PET-CT depicts abnormal FDG-accumulation of a 3 cm right upper lobe mass (C) with presumed post-obstructive atelectasis.
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The chest CT scan showed a solid mass measuring 3.0 cm in the right upper lung (Fig. 3), and we performed bronchoscopy, which revealed right B1+2 branching in the upper lobe and B3 branching from a common trunk with the right middle lobe branch (Fig. 4). PET-CT revealed abnormal FDG-accumulation with a maximum standardized uptake value of 33.0 at the lung mass and 4.1 at the right hilar lymph node (Fig. 3).