This 68 y/o male presented with acute onset of shortness of breath. His medical history was unremarkable with no past history of significant illness. Physical exam and EKG were within normal limits. Blood gases showed hypoxemia. A chest x-ray, posterior Xe133 ventilation scan with rebreathing and washout phases and a Tc99m MAA perfusion scan with multiple projections were performed. Selected images shown above demonstrate findings consistent with a large central lesion. A chest CT was performed confirming the diagnosis. A subsequent biopsy demonstrated a bronchogenic carcinoma.

  1. White RI Jr, James AE Jr, Wagner HN Jr. The significance of unilateral absence of pulmonary artery perfusion by lung scanning. Am J Roentgenol Radium Ther Nucl Med 1971 Mar;111(3):501-9 UI:71139155
  2. Stanley DC, Cho SR, Tisnado J, Vines FS, Coyne SS. Pulmonary arteriography in patients with hilar or mediastinal masses and lung scans suggesting pulmonary embolism. South Med J 1981 Aug;74(8):960-4, 967 UI:81275004
  3. Tomsick TA, Holder LE. Unilateral absent perfusion of the lung. JAMA 1975 Oct 6;234(1):89-90 UI:76007980
  4. Gandhi V, Shapiro JM. Unilateral absent pulmonary perfusion due to bronchogenic carcinoma. South Med J 1998 Apr;91(4):392-4 UI:98222900
  5. Rosen RJ, Goodman LR. Occult bronchogenic carcinoma masquerading as recurrent pulmonary embolism. AJR Am J Roentgenol 1979 Jan;132(1):133-5 UI:79079968
  6. Assallo CL, Gee JB, Wholey MH, Vester JW. Lung scanning in hilar bronchogenic carcinoma. Am Rev Respir Dis 1968 May;97(5):851-8 UI:68230853
  7. Didolkar MS, Takita H. Lung scan in the diagnosis of bronchogenic carcinoma. J Surg Oncol 1974;6(3):225-9 UI:74280681
  8. Garnett ES, Goddard BA, Fraser HS, Macleod WM. Lung perfusion patterns in carcinoma of bronchus. Br Med J 1968 Apr 27;2(599):209-10 UI:68273974
  9. Hatch HB Jr, Maxfield WS, Ochsner JL. Radioisotope lung scanning in bronchogenic carcinoma. J Thorac Cardiovasc Surg 1965 Nov;50(5):634-9 UI:66042126
  10. Macumber HH, Calvin JW. Perfusion lung scan patterns in 100 patients with bronchogenic carcinoma. J Thorac Cardiovasc Surg 1976 AUG;72(2):299-302 UI:76266108
  11. Chiti A, Schreiner FA, Crippa F, Pauwels EK, Bombardieri E. Nuclear medicine procedures in lung cancer. Eur J Nucl Med 1999 May;26(5):533-55 UI:99311108
  12. Dunn EK. Disorders associated with extensive unilateral abnormalities in ventilation/perfusion or perfusion scintigraphy. Crit Rev Diagn Imaging 1995;36(4):339-83 UI:96111215

Use the Back or Backward button on your browser to return