PMC9637803_01
(A-D)Plain chest computed tomography. These images show the nodule (arrow) in the left lower lobe in the order of time series. A: One year previous from the surgery. B: Eleven months previous from the surgery. C: Five months previous from the surgery. D: Three and a half months previous from the surgery.
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One year previously, a new nodule 25 mm in diameter with niveau formation along a bulla wall was detected incidentally in his left lower lobe on an annual chest computed tomography (CT) scan (Fig. 1A). One month later, the nodule had decreased in size to a diameter of 19 mm (Fig. 1B); however, it further increased in size to a diameter of 25 mm with niveau formation at the 6-month follow-up (Fig. 1C). The 1.5-month follow-up CT showed further growth of the nodule with niveau resolution and a cavity filled with low-density content (Fig. 1D), suggesting the need to rule out the possibility of lung cancer. Chest CT, taken prior to the hospitalization, showed emphysematous changes, reticular opacities, and an increase in nodule size to 43 mm (Fig. 1D).
Positron emission tomography-computed tomography. This shows the increased fluorodeoxyglucose uptake in the nodule.
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Fluorodeoxyglucose-positron emission tomography (FDG-PET) showed increased FDG uptake in the lesion (maximal standardized uptake value [SUVmax] = 3.8) (Fig. 2).