Usefulness of dynamic fluorodeoxyglucose positron emission tomography/computed tomography in diagnosing pulmonary arteriovenous malformation mimicking a lung tumour

Abstract

A 61-year-old male patient with known kidney dysfunction who underwent a non-contrast thorax CT and was then referred to our department for metabolic assessment of solitary pulmonary nodule (SPN). The patient underwent dynamic FDG PET/CT to differentiate benign from malignant SPN. This case illustrates the usefulness of dynamic FDG PET/CT imaging when assessing SPN especially in patients with suspicion for pulmonary arterio-venous malformation accompanying renal failure or contrast allergy.

Pulmonary arteriovenous malformation and inherent complications with solitary lung nodule biopsy—literature overview and case report

“…However, in cases in which the patient is allergic to embolization materials, particularly in cases of metal allergies, urgent surgical resection of the cystic lung should be prioritized [4] . The differential diagnosis of solitary pulmonary nodules in developed countries often relies on positron emission tomography/CT to determine the presence of possible malignancy, especially in patients with renal failure or allergies to contrast media [5] .…”

“…The pulmonary veins draining the dilated sacs appear dilated and extend toward the hilum. The PAVM sac can expand slowly over a long period of time, but rapid enlargement can also occur [1 , 4 , 5] .…”

“…When the PAVM sac is larger than 1-2 cm, the supplying artery is often easily discernible. In general, the incoming vessel diameter is usually half the PAVM sac diameter [1 , [5] , [6] , [7] .…”