Atypical Presentation of COVID-19 Incidentally Detected at 18F-FDG PET/CT in an Asymptomatic Oncological Patient (original) (raw)
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18F-FDG PET/CT in asymptomatic patients with COVID-19: The submerged iceberg surfaces
Purpose: the aim of this case series is to describe our experience in diagnosis and management of oncological asymptomatic patients with COVID-19 submitted to 18F-FDG PET/CT.Methods: from March 9 to March 31, 2020, we identified 5 patients who had PET/CT findings suspicious for COVID-19, but no symptom of infection.Results: the first three patients performed SARS-CoV-2 test in a COVID-dedicated centre, while the fourth and fifth in our Institution, in agreement with a new internal procedure. The SARS-CoV-2 test yielded positive results in all five patients.Conclusions: in this COVID-19 emergency, our task as nuclear medicine physicians is to be able to identify imaging findings suggestive of the disease and to manage patients without overload the hospital system.
Asymptomatic COVID–19 cancer patients incidentally discovered during F18-FDG PET/CT monitoring
2021
Background The aim of the study was to present the PET/CT imaging features in a small series of asymptomatic patients with known cancer pathologies, infected with the SARS-CoV-2 virus, which were incidentally discovered during their monitoring scan of F18-FDG PET/CT. Methods We included in our study a number of five cases (3 female and 2 male) out of 478 patients examined by F18-FDG PET/CT between March – April 2020, with confirmed diagnostic of cancer. Four patients had lung damages suggestive for the mentioned viral infection and 1 patient had multiple lung metastases from thyroid cancer. All patients were asymptomatic for acute respiratory disease at the time of examination, being subsequently confirmed for the viral infection by specific PCR analysis. Results The asymptomatic positive SARS-CoV-2 cancer patients discovered incidentally in PET/CT F18-FDG represent 0.83% and their imaging characteristics were suggestive for high FDG activity in the lung despite the lack of respirat...
Eur J Nucl Med Mol Imaging, 2020
Abstract Background Lung involvement in patients with coronavirus disease 2019 (COVID-19) undergoing PET-CT has been previously reported. However, FDG uptake outside lung parenchyma was poorly characterized in detail. We evaluated the extraparenchymal lung involvement in asymptomatic cancer patients with COVID-19 pneumonia through 18F-FDG PET-CT. Methods A total of 1079 oncologic 18F-FDG PET-CT were performed between February 2 and May 18, 2020. Confirmed COVID-19 pneumonia was defined as characteristic ground-glass bilateral CT infiltrates and positive genetic/serologic tests. Nonmetastatic extra-parenchymal lung PET-CT findingswere evaluated through qualitative (visual), quantitative (measurements on CT), and semiquantitative (maximum standardized uptake value: SUVmax on PET) interpretation. Clinical data, blood tests, and PET-CT results were compared between patients with and without COVID-19 pneumonia. Results A total of 23 18F-FDG PET-CT scans with pulmonary infiltrates suggestive of COVID-19 and available laboratory data were included: 14 positive (cases) and 9 negative (controls) for COVID-19 infection, representing a low prevalence of COVID-19 pneumonia (1.3%). Serum lactate dehydrogenase and D-dimers tended to be increased in COVID-19 cases. Extraparenchymal lung findings were found in 42.9% of patients with COVID-19, most frequently as mediastinal and hilar nodes with 18F-FDG uptake (35.7%), followed by incidental pulmonary embolism in two patients (14.3%). In the control group, extrapulmonary findings were observed in a single patient (11.1%) with 18F-FDG uptake located to mediastinal, hilar, and cervical nodes. Nasopharyngeal and hepatic SUVmax were similar in both groups. Conclusion In cancer patients with asymptomatic COVID-19 pneumonia, 18F-FDGPET-CT findings are more frequently limited to thoracic structures, suggesting that an early and silent distant involvement is very rare. Pulmonary embolism is a frequent and potentially severe finding raising special concern. PET-CT can provide new pathogenic insights about this novel disease.
Coincidental Lung Mass Diagnosis in COVID-19 Infected Patient: A Case Report
Phoenix Medical Journal, 2020
Introduction: COVID-19 (Corona Virus Disease-19) is a newly discovered virus that caused pandemic infection worldwide. The imaging methods are crucial for diagnosis and follow-up in this infectious period. In this article, a case with coronavirus, which was diagnosed as lung cancer incidentally, is presented. Case report: A 41-year-old man presented to the emergency room with cough, fever, and shortness of breath. On examination, breathing sounds changed by listening in the lung. Lung computerized tomography was performed due to shortness of breath while waiting for the PCR test. In addition to the findings of atypical viral pneumonia compatible with coronavirus infection in the tomography, there was a 44x64mm mass in the right lung middle lobe. Coronavirus treatment was initiated in the patient, whose PCR test was positive. The patient who responded to the treatment after one week was diagnosed as lung cancer as a result of the biopsy. Conclusion: In the diagnosis of COVID-19, imag...