title: Left is right and right is wrong: Fluorodeoxyglucose uptake in left hemi-diaphragm due to right phrenic nerve palsy.
abstract: A 36-year-old Indian man, a recently diagnosed case of the right lung carcinoma underwent fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) for staging of the malignancy. PET/CT showed increased FDG uptake in the right lung mass, consistent with the known primary tumor. Right hemidiaphragm was found to be elevated on CT, suggesting right diaphragmatic paresis. The PET scan demonstrated asymmetric, intense FDG uptake in the left hemidiaphragm and accessory muscles of respiration, which was possibly due to compensatory increased workload related to contralateral right diaphragmatic paresis. The right diaphragmatic paresis was hypothesized to be caused by phrenic nerve palsy by right lung neoplasm.
authors.affiliation: Department of Nuclear Medicine and PET-CT, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.
authors.forename: Prathamesh
authors.initials: P
authors.lastname: Joshi
authors.forename: Vikram
authors.initials: V
authors.lastname: Lele
keywords: Diaphragmatic fluorodeoxyglucose uptake; fluorodeoxyglucose; muscle uptake of fluorodeoxyglucose; phrenic nerve palsy; positron emission tomography-computed tomography
references.citation: J Cancer Res Ther. 2012 Jul-Sep;8(3):451-3
references.pmid: 23174735
references.citation: J Physiol. 2002 Jul 15;542(Pt 2):403-12
references.pmid: 12122141
references.citation: J Nucl Med. 2003 Oct;44(10):1592-8
references.pmid: 14530472
references.citation: J Nucl Med Technol. 2006 Mar;34(1):29-33
references.pmid: 16517966
references.citation: Chest Surg Clin N Am. 1998 May;8(2):237-80
references.pmid: 9619304
references.citation: Eur J Appl Physiol. 2000 Nov;83(4 -5):297-302
references.pmid: 11138567
references.citation: J Nucl Med. 1999 Jan;40(1):70-6
references.pmid: 9935060
references.citation: J Thorac Cardiovasc Surg. 1982 Dec;84(6):861-4
references.pmid: 6292583
references.citation: Clin Nucl Med. 2005 Mar;30(3):159-64
references.pmid: 15722818
references.citation: Am J Physiol. 1999 Aug;277(2):E361-9
references.pmid: 10444433