Image in medicine
Pleuroparenchymal fibroelastosis in a patient with lung cancer: Usefulness of PET/CT
Fibroelastosis pleuroparenquimatosa en paciente con cáncer de pulmón: utilidad de la PET/TC
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Thoracic CT confirmed a lung mass in the left upper lobe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, m) and an irregular pleural thickening involving both apices with reticular subpleural fibrosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, asterisks); the uppermost aspect of the mass contacted with the subpleural fibrosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, arrow), making it difficult to exclude spread of the tumor outside the mass. PET/CT confirmed that the pleural apical thickening, unlike the hypermetabolic mass (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C, asterisk), did not show any FDG uptake, suggesting a benign nature (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C, arrows). The patient underwent a successful left upper lobectomy, which confirmed a localized large-cell lung cancer. Histological analysis of the pleural thickening confirmed a pleuroparenchymal fibroelastosis (PPFE).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">PPFE is a rare fibrotic disease with poor prognosis characterized by pleural fibrosis and fibroelastosis of the subjacent lung parenchyma. Although considered idiopathic, PPFE may be associated with autoimmune diseases, bone marrow transplantation, radiation therapy, and chemotherapy. An association with lung cancer has only been previously described in three patients (two of which were also large-cell lung carcinomas). Our case adds to the existing scant literature that PPFE may also be associated with lung cancer and that PET/CT may be useful for differentiating hypermetabolic tumor lesions from less metabolic PPFE areas.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors’ contribution</span><p id="par0015" class="elsevierStylePara elsevierViewall">The five authors have participated in the conception and design of the manuscript. LG was in charge of the writing and review of the paper, whereas OAI, ACS, SFF and AGG were in charge of the preparation and edition of the images.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Authors’ contribution" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 392 "Ancho" => 1000 "Tamanyo" => 64708 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015700000004/v2_202201010719/S2387020621003922/v2_202201010719/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015700000004/v2_202201010719/S2387020621003922/v2_202201010719/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621003922?idApp=UINPBA00004N" ]
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