case_images: PMC6020462_01
case_images: Consolidation at both perihilar regions more on the left side with possible small nodules.
case_images: CRIM2018-1903757.001.jpg
case_images: PMC6020462_01_CRIM2018-1903757.001.jpg
case_images: fig1
case_images: During routine workup in emergency, a chest X-ray was done, which was suggestive of bilateral fluffy hilar opacities (Figure 1), and a CT thorax was done (Figures 2 and 3), which was suggestive of scattered areas of multifocal consolidation noted in the left lung and areas of scattered mosaic perfusion noted in the subpleural region, small nodules are also noted in the right lung, and both hila are prominent.
case_images: Axial lung window shows scattered areas of multifocal consolidation noted in the left lung.
case_images: CRIM2018-1903757.002.jpg
case_images: PMC6020462_01_CRIM2018-1903757.002.jpg
case_images: fig2
case_images: During routine workup in emergency, a chest X-ray was done, which was suggestive of bilateral fluffy hilar opacities (Figure 1), and a CT thorax was done (Figures 2 and 3), which was suggestive of scattered areas of multifocal consolidation noted in the left lung and areas of scattered mosaic perfusion noted in the subpleural region, small nodules are also noted in the right lung, and both hila are prominent.
case_images: CT bone window showing sclerotic bone metastases.
case_images: CRIM2018-1903757.003.jpg
case_images: PMC6020462_01_CRIM2018-1903757.003.jpg
case_images: fig3
case_images: During routine workup in emergency, a chest X-ray was done, which was suggestive of bilateral fluffy hilar opacities (Figure 1), and a CT thorax was done (Figures 2 and 3), which was suggestive of scattered areas of multifocal consolidation noted in the left lung and areas of scattered mosaic perfusion noted in the subpleural region, small nodules are also noted in the right lung, and both hila are prominent.
case_images: PET scan before treatment: (a) bone metastasis (hot lesions); (b) left axillary lymph nodes, and bone and lung metastasis; (c) multiple spine metastasis; (d) left lung hot lesion (adenocarcinoma); (e) left axillary lymph node metastasis.
case_images: CRIM2018-1903757.004.jpg
case_images: PMC6020462_01_CRIM2018-1903757.004.jpg
case_images: fig4
case_images: PET scan after treatment: (a) no more hot lesions in the bone; (b) no more hot lesions in the axilla, bone, and lung; (c) no spine metastasis; (d) no hot lesion in the lung; (e) no hot lesion in the left axillary lymph node.
case_images: CRIM2018-1903757.005.jpg
case_images: PMC6020462_01_CRIM2018-1903757.005.jpg
case_images: fig5
case_images: Patient started on chemotherapy with crizotinib 200 mg BID and denosumab 120 mg q 4 weekly subcutaneous with good response according to the new PET scan (Figure 5).