Pulmonary suture abscess with false-positive 18F-fluorodeoxyglucose positron emission scan mimicking lung cancer recurrence.
We present the case of a 57-year-old woman with pulmonary suture abscess. She had undergone right S3 segmentectomy for early lung adenocarcinoma 7 years before and right breast-conserving surgery for invasive ductal carcinoma 5 months previously, followed by irradiation plus endocrine therapy. Chest radiography and computed tomography revealed an irregular mass (3.5 cm in diameter) between the residual S1 segment and the middle lobe, neighboring the staple line of the segmentectomy. 18F-fluorodeoxyglucose uptake into the mass increased, seen by positron emission scans. Therefore, we could not rule out the possibility of local recurrence of lung cancer and resected it. Pathologically and microbiologically, the mass was a suture abscess arising around the nylon suture of the previous segmentectomy. This lesion was the result of a foreign-body reaction, as confirmed by polarized microscopy. Moreover, titanium staples at the segmentectomy and breast-conserving surgery may also have contributed to this condition.
Iwasaki
Teruo
T
Department of Respiratory Surgery, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Japan. teruteruah@m4.dion.ne.jp
Nakagawa
Katsuhiro
K
Katsura
Hiroshi
H
Nakane
Shigeru
S
Kawahara
Kunimitsu
K
Fukuda
Haruyuki
H
D000230:Adenocarcinoma / Q000601:surgery; D001943:Breast Neoplasms / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008169:Lung Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008175:Lung Neoplasms / Q000601:surgery; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011013:Pneumonectomy; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D013537:Sutures / Q000009:adverse effects*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18