Background: Fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan is an indicator of potential malignancy or infection. Patients with a history of talc pleurodesis can develop pleural or lung parenchymal nodules/talcomas. In these patients, talc-associated (non-malignancy-related) FDG uptake may occur over years. Case Report: A 66-year-old female presented with a past medical history significant for resected non-small-cell lung cancer and was treated with chemotherapy/radiation. The referring physician indicated that she subsequently developed benign pleural effusions and had talc pleurodesis to limit recurrence. The patient was referred to our institution for endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) due to a new left upper lobe nodule with increasing FDG uptake on follow-up interval PET performed at the referring institution. On-site cytologic evaluation showed no evidence of malignancy, but found refractile foreign material, consistent with the presence of talc particles. Conclusion: This case presents the importance of cytologic recognition of talc particles during on-site evaluation and discusses the phenomenon of increasing PET-FDG uptake associated with talc pleurodesis.

Keywords:
Rapid on-site evaluation, Talc pleurodesis, Fluorodeoxyglucose uptake, Positron emission tomography scan, Fine-needle aspiration
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© 2017 S. Karger AG, Basel
2017
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