PET avid lung mass in a neurofibromatosis patient: a case report

Abstract

The differential diagnosis of a lung mass in a neurofibromatosis patient includes benign or malignant neurogenic neoplasm. Benign neurogenic neoplasms can transform to malignant and since this transformation is a major cause of mortality, the prognosis will depend on early detection. Computed tomography scans, magnetic resonance imaging and positron emission tomography are not able to differentiate benign from malignant neurogenic neoplasm. Needle biopsy has poor sensitivity and malignant neurogenic neoplasm can be misinterpreted as benign. We address these issues in the case of a 48 year old man with neurofibromatosis type 1 who incidentally was found to have a right apex lung mass. The needle biopsy showed spindle cell lesion of probable neurogenic origin. Given the concern about the adequacy of needle biopsy in providing an accurate diagnosis, a positron emission tomography scan was done and it showed high uptake within the lesion. The mass was resected and confirmed as neurofibroma