PMC8487972_01
1A: Pulmonary nodule with bulla in right lower lobe without solid component. 1B: Increased solid component within the right lower lobe bulla. 1C: PET with mild increased FDG (max SUV of 0.5) uptake of solid component. 1D: Histopathological tissue examination. 1E: Congo-Red staining. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Case 1: A 75-year-old woman with a history of asthma, emphysema, bronchiectasis, and a 48 pack-year smoking history was found to have sub centimeter ground glass pulmonary nodules with bulla in the right lower lobe (RLL) (Fig. 1A). Follow-up CT chest demonstrated an increased solid component within the RLL bulla (Fig. 1B) with associated mild FDG uptake with a maximum Standardized Uptake Value (SUV) of 0.5 on a subsequent PET scan (Fig. 1C).
PMC8487972_02
2A: Pulmonary nodule in right lower lobe, 1.6 cm x 1.8 cm. 2B: 1.6 cm nodule with calcification thus likely benign. (Note the calcified pleural plaque adjacent to aorta due to hx of asbestos exposure). 2C: Increase in size of pulmonary nodule, now 2 cm x 1.8 cm. 2D: Histopathological tissue examination.
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Case 2: A 77-year-old man with a history of interstitial lung disease, asbestos exposure, pleural plaques, prior tobacco use, atrial fibrillation treated with amiodarone, and 7 pack-year smoking history was being followed for a 1.6cm RLL nodule which was favored to be benign given focus of calcification (Fig. 2A-B). Follow-up CT identified an interval increase in the size of the RLL mass to 2 cm with an associated increase in the prominence of calcified prevertebral adenopathy (Fig. 2C). A PET-CT scan demonstrated moderate FDG uptake (max SUV of 4.1) in the RLL lesion and interval increase in the FDG uptake (max SUV of 5.9) in prevertebral calcified lymph nodes (Fig. 2D).