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2. The new lung nodules raise a concern for metastatic cancer
Although a Jo 1 antibody is one of the more frequent antisynthetase antibodies associated with DM/PM, a negative result does not exclude DM/PM as there are other less common antibodies associated with these disorders and more extended testing for myositis-associated antibodies is recommended if there is a strong clinical suspicion. To our knowledge there is no such thing as “dermatomyositis nodules”.
DM/PM is associated with various cancers and the detection of multiple new lung nodules is concerning for a cancer with lung metastasis. A positron emission tomography (PET) scan was ordered because of the concern for possible cancer (Figure 4).
Figure 4. PET scan showing increased uptake in the right perihilar and left peritracheal regions.
What should be done at this time? (Click on the correct answer to be directed to the sixth of seven pages)