SARS-CoV-2 pneumonia incidentally detection on 18F-FDG PET/CT in an asymptomatic patient during follow-up for esophagel cancer

Abstract

Aim: To present a case report about 71-year-old man with a positive history of esophageal cancer with stable mediastinal and hilar lymph nodes metastases who underwent a follow-up18F-FDG PET/CT imaging. The examination incidentally showed SARS-CoV-2 (COVID-19) pneumonia. Method: The patient with esophageal cancer after treatment and stable mediastinal and hilar lymph nodes metastases underwent a follow-up18F-FDG PET/CT examination. The patients was asymptomatic without cough or fever. The PET/CT scan was obtained 60 minutes after intravenous injection of18F-FDG. The PET scan acquisition time was 2.5 minutes per bed position and seven bed positions were nec-essary. Contrast-enhanced CT (venous phase) provided both full CT evaluation (including intravenous and oral contrast) and PET attenu-ation correction. Results: In addition to demonstrating stable 18 F-FDG-avid metastases in mediastinal and hilar lymph nodes, the PET/CT incidentally detected18F-FDG-avid bilateral pulmonary ground glass and subpleural opacities. The finding was suggestive of COVID-19 associated pneumonia. The infection of SARS-CoV-2 was subsequently confirmed by PCR test. Conclusion:18F-FDG PET/CT imaging correctly detected a latent COVID-19 pneumonia in an asymptomatic patient with a positive history of esophageal cancer and mediastinal and hilar lymph nodes metastases and led to a correct anti-epidemic arrangement.