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2. Lung PET scan
The effusion is transudative by Light’s criteria (pleural fluid/serum protein <0.5 and pleural fluid/serum LDH <0.6 or <2/3 the upper limit of the serum normal, 4). It is unusual for patients with lung cancer to present with a transudative effusion and when it occurs it is most often seen with coexisting congestive heart failure (5). We were still troubled that the clinical history was not totally explained by congestive heart failure, the patient’s hemoptysis and the focal lung consolidation or mass. A pleuroscopy is reasonable but probably overly invasive at this juncture. Therefore, a lung PET scan was performed which showed increased tracer uptake in the left lung (Figure 3).
Figure 3. Representative image from lung PET scan showing increased uptake of FDG (fluorine-18 combined with deoxy-glucose) in the left lung.
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