Week 246: Case 4

1. Presented by Peter Illei, M.D. and prepared by Kara Judson, M.D.

This 53 year-old man developed painful and red feet 12-18 months ago. After several months with no specific diagnosis Wegener's granulomatosis was suspected and a systemic work up was performed. Chest CT scan showed a 2.8 cm left lower lobe nodule that radiologically was consistent with either Wegener's granulomatosis or a primary lung cancer. A CT-guided needle biopsy showed non-small-cell lung cancer. Total body PET scan showed intense uptake in the left lower lobe, as well as the left hilar region, and inflammation in his ankles and feet. He underwent fiber optic bronchoscopy and left lower lobectomy.

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