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False positive 18FDG PET-CT results due to exogenous lipoid pneumonia secondary to oily drug inhalation: A case report.

Abstract Exogenous lipoid pneumonia is a rare condition due to abnormal presence of oily substances in the lungs. It is a rarely known cause for false positive FDG PET-CT results and can sometimes lead to invasive investigations. Searching and finding the source of the oily substance is one of the keys to the diagnosis. Inhalation of oily drugs during snorting has rarely been described.
PMID
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Authors

Mayor MeshTerms

Positron Emission Tomography Computed Tomography

Keywords
Journal Title medicine
Publication Year Start




PMID- 28562539
OWN - NLM
STAT- MEDLINE
DA  - 20170531
DCOM- 20170626
LR  - 20170626
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 22
DP  - 2017 Jun
TI  - False positive 18FDG PET-CT results due to exogenous lipoid pneumonia secondary
      to oily drug inhalation: A case report.
PG  - e6889
LID - 10.1097/MD.0000000000006889 [doi]
AB  - RATIONALE: Exogenous lipoid pneumonia is a rare condition due to abnormal
      presence of oily substances in the lungs. It is a rarely known cause for false
      positive FDG PET-CT results and can sometimes lead to invasive investigations.
      Searching and finding the source of the oily substance is one of the keys to the 
      diagnosis. Inhalation of oily drugs during snorting has rarely been described.
      PATIENT CONCERNS: A patient with well controlled HIV infection was referred for
      an FDG PET-CT to assess extension of Kaposi's disease, recently removed from his 
      right foot. The patient had no particular symptoms. DIAGNOSES: Abnormal uptake of
      FDG was found in a suspicious lung nodule. An experienced radiologist thought the
      nodule was due to lipoid pneumonia. INTERVENTIONS: Bronchoalveolar lavage fluid
      did not contain lipid-laden macrophages but bronchoscopy showed violet lesions
      resembling Kaposi's disease lesions. Lobectomy was performed after a
      multidisciplinary discussion. OUTCOMES: Anatomopathological analysis revealed the
      nodule was due to lipoid pneumonia. The patient's quality of life did not
      diminish after the operation and he is still in good health. The source of the
      oily substance causing lipoid pneumonia was found after the surgery: the patient 
      used to snort oily drugs. LESSONS: The presence of a suspicious lung nodule
      possibly due to lipoid pneumonia in a patient with known Kaposi's disease was
      difficult to untangle and lead to invasive surgery. It is possible that if a
      source of exogenous lipoid pneumonia had been found beforehand, surgery could
      have been prevented.
FAU - Chardin, David
AU  - Chardin D
AD  - aDepartment of Nuclear Medicine, Centre Hospitalier Regional et Universitaire de 
      Nice, Hopital Archet I bLaboratoire de Pathologie Clinique et Experimentale
      cDepartment of Radiology, Centre Hospitalier Regional et Universitaire de Nice,
      Hopital Pasteur II, Nice, France.
FAU - Nivaggioni, Guillaume
AU  - Nivaggioni G
FAU - Viau, Philippe
AU  - Viau P
FAU - Butori, Caherine
AU  - Butori C
FAU - Padovani, Bernard
AU  - Padovani B
FAU - Grangeaon, Caroline
AU  - Grangeaon C
FAU - Razzouk-Cadet, Micheline
AU  - Razzouk-Cadet M
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Oils, Volatile)
RN  - 0 (Radiopharmaceuticals)
RN  - 0Z5B2CJX4D (Fluorodeoxyglucose F18)
SB  - AIM
SB  - IM
MH  - False Positive Reactions
MH  - Fluorodeoxyglucose F18
MH  - HIV Infections/complications/diagnostic imaging
MH  - Humans
MH  - Inhalation Exposure/adverse effects
MH  - Lung/*diagnostic imaging/pathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Oils, Volatile/administration & dosage/*adverse effects
MH  - Pneumonia, Lipid/*diagnostic imaging/*etiology/pathology/surgery
MH  - *Positron Emission Tomography Computed Tomography
MH  - Radiopharmaceuticals
MH  - Sarcoma, Kaposi/complications/diagnostic imaging
MH  - Substance-Related Disorders/*complications/diagnostic imaging/pathology/surgery
PMC - PMC5459704
EDAT- 2017/06/01 06:00
MHDA- 2017/06/27 06:00
CRDT- 2017/06/01 06:00
AID - 10.1097/MD.0000000000006889 [doi]
AID - 00005792-201706020-00015 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jun;96(22):e6889. doi: 10.1097/MD.0000000000006889.