True or false: There is bone marrow uptake in ribs.
False. Uptake is in intercostal muscles.
True or false: FDG-uptake in pulmonary lesions is highly suggestive of lymphoma infiltration.
False. The inherent high sensitivity and specificity of CT far outweighs accuracy of PET in pulmonary findings.
What do you think about the pulmonary changes? Is infection still most likely?
The marked ground-glass opacities with bronchiectasis and sub pleural changes are suggestive of hypersensitivity pneumonitis (subacute phase).
What is the next step in patient management?
High resolution CT and bronchioalveolary lavage BAL are good options.
Apical parts of lung with ground-glass opacities and sub pleural cystic changes.
Posterior predominance with interspersed normal lung tissue.
Coronal MinIP better depicts bronchiectasis, bronchiolectasis and subpleural changes.
Moderate FDG-uptake in ground-glass opacities.
FDG-uptake in accessory respiration muscles and crus diaphragmatica.