PET positive pleural plaques decades after pleurodesis: mesolthelioma?

Abstract

A 59-year-old patient was evaluated for abnormal chest CT and hypermetabolic pleural foci on FDG-PET scan. The scans were obtained as routine surveillance for resection of an in situ pancreatic tumor. The patient had a remote history of automobile manufacturing and the abnormalities were suggestive of asbestos exposure. Because hypermetabolic areas were concerning for pleural malignancy, a VATS lung biopsy was performed and revealed chronic talc-induced pleuritis. The patient had a history of pnemothoraces with bilateral talc pleurodesis at the age of 16. As cancer screening and surveillance increasingly relies on extensive imaging modalities, physicians should be aware of the chronic complications of talc pleurodesis and the possibility of false positive imaging tests.

Keywords

• PET scanning
• pleural plaques
• mesothelioma
• pleurodesis