Anthracotic Solitary Pulmonary Nodule Imitating Lung Malignancy on F-18 FDG PET/CT Imaging

An asymptomatic 68-year-old man with suspected prostate cancer was referred for F-18 FDG PET/CT imaging for characterization of an incidental solitary pulmonary nodule. The left lingular nodule demonstrated corresponding hypermetabolic activity. Histopathologic diagnosis from transbronchial tissue biopsy disclosed anthracotic lung tissue with congestion. Although anthracosis is a form of pneumoconiosis typically observed in coal workers, in this patient, exposure to fuel exhaust and prior smoking seemed to be the only risk factors. Anthracotic nodule should be added to the list of causes for F-18 FDG active pulmonary lesions.