title: Lung Nodule with Increasing Fluorodeoxyglucose Uptake in a Patient with a History of Lung Carcinoma and Talc Pleurodesis Evaluated by EBUS-TBNA On-Site Assessment.
abstract: BACKGROUND
  Fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan is an indicator of potential malignancy or infection. Patients with a history of talc pleurodesis can develop pleural or lung parenchymal nodules/talcomas. In these patients, talc-associated (non-malignancy-related) FDG uptake may occur over years.
  
  
  METHODS
  A 66-year-old female presented with a past medical history significant for resected non-small-cell lung cancer and was treated with chemotherapy/radiation. The referring physician indicated that she subsequently developed benign pleural effusions and had talc pleurodesis to limit recurrence. The patient was referred to our institution for endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) due to a new left upper lobe nodule with increasing FDG uptake on follow-up interval PET performed at the referring institution. On-site cytologic evaluation showed no evidence of malignancy, but found refractile foreign material, consistent with the presence of talc particles.
  
  
  CONCLUSIONS
  This case presents the importance of cytologic recognition of talc particles during on-site evaluation and discusses the phenomenon of increasing PET-FDG uptake associated with talc pleurodesis.
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Kurian
mesh_terms: D000368:Aged; D001692:Biological Transport; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008168:Lung / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D008175:Lung Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D010996:Pleural Effusion / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D018700:Pleurodesis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D013627:Talc / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013627:Talc