| خلاصه مقاله | A 74-year-old woman with a previous history of asthma, diabetes mellitus, hypertension, and cervical vessel stenting after falling recently underwent CT scan. Several pulmonary masses were randomly identified in the chest CT report, including one with a diameter of 30 mm in the upper lobe of the right lung. There was a possibility of carcinomatosis lymphangitis due to the RUL lesion and interstitial edema, and further evaluation was recommended.
On the control CT performed 10 days later, the same masses were found without changes, also several enlarged lymph nodes in the mediastinum and lungs' hilum, and no evidence of thrombosis or pulmonary artery stenosis on both sides. 99mTc (V)-DMSA imaging was requested by the attending physician for further evaluation of pulmonary masses. The whole body scan, as well as thoracic SPECT images, were taken two hours after the intravenous injection of 590 MBq of 99mTc (V)-DMSA. The scan showed two lesions with increased radiotracer uptakes, one in the lower region of upper lobe and the other in the superior segment of Rt. and Lt. lungs respectively. The lesions had posterior locations in both lungs best detected by SPECT projections. In semi-quantitative analysis, the lesion to background ratio was 1.52 on the right side and 1.61 on the left side. As well, there were some patchy lesions with slightly increased uptake in the upper and middle parts of both lungs. The possibility of malignancy in two obvious lesions in the right and left lungs based on the 99mTc (V)-DMSA scan report. Consequently, the patient underwent lung transbronchial biopsy and bronchial washing cytology which showed the result of lung cancer, adenocarcinoma poorly differentiated. The chemotherapy was started for this patient |