Correct!
5. Fungal infection

The lack of fever and the imaging findings argue against bacterial pneumonia. The lung nodule and lymph node enlargement as well as the appearance of the lung opacities are not suggestive of either acute COVID-19 or post-acute sequelae of COVID-19. Pulmonary lymphoma is a possibility, but often when lymphoma is present in the lungs, it is the result of direct invasion from affected lymph nodes or presents as multiple lung nodules without mediastinal or peribronchial lymphadenopathy- neither is the case in this circumstance. Multifocal adenocarcinoma in the lungs commonly presents as multiple small nodules which may be non-solid in appearance or as multifocal areas of consolidation, with or without cystic change.
The imaging findings were regarded as suspicious for possible bronchogenic malignancy and the patient underwent 18FDG – PET scan (Figure 3).

Figure 3. Axial (A) and coronal (B and C) FDG-PET images.

Which of the following represents an appropriate interpretationfor this examination? (Click on the correct answer to be directed to the sixth of fourteen pages).

1. 18FDG – PET shows widespread hypermetabolic activity beyond the hypermetabolism in the lung nodule and right peribronchial and mediastinal lymph node enlargement 
2. 18FDG – PET shows hypermetabolic activity in the right upper lobe nodule but not in the peribronchial or mediastinal lymph node enlargement
3. 18FDG – PET is non-diagnostic, probably owing to improper fasting
4. 18FDG – PET shows hypermetabolic activity in interstitial lung abnormalities
5. 18FDG – PET shows hypermetabolic activity in the right upper lobe nodule as well as in the peribronchial or mediastinal lymph node enlargement

Home/Imaging