Pulmonary hypertrophic osteoarthropathy in a patient with nonsmall cell lung cancer: Diagnosis with FDG PET/CT.

摘要

A partial whole-body PET/CT scan using F-18 FDG was performed for staging in a 62-year-old male smoker with cytologic-proven nonsmall cell lung cancer (NSCLC) of the right upper lobe. PET/CT showed increased FDG accumulation in the primary lung carcinoma, in ipsilateral mediastinal lymph node metastases, and in a solitary metastasis in the left iliac bone. In addition, slightly increased FDG uptake along the periosteum of both femurs was observed. Bone windows on CT showed discrete periosteal reactions. The findings were interpreted as pulmonary hypertrophic osteoarthropathy (PHOA). The diagnosis of PHOA was confirmed clinically by typical digital clubbing and additionally a bone scan was performed. Together with clubbed fingers and toes with eyeglass shape of the nails, neurovegetative disturbances, and dysproteinemia, the disease is also called Pierre-Marie-Barnberger syndrome.