A 55-year-old male smoker in Wuhan, China, developed intermittent fever, fatigue, and dry cough for 5 days. The initial chest CT findings from an outside institution suggested lung malignancy. Fluorine 18 fluorodeoxyglucose (FDG) PET/CT was performed for further evaluation.

The PET maximum intensity projection image (Figure, part A) depicted an FDG-avid mass with a maximum standardized uptake value of 4.9 in the right lung. Increased accumulation of FDG was noted in the right paratracheal and right hilar lymph nodes as well as in bone marrow. Axial images (Figure, parts B, C) showed ground-glass opacities with areas of focal consolidation primarily in the right upper lobe and a focal opacity in the left upper and right middle lobes. Influenza, respiratory syncytial virus, and other common respiratory virus infections were excluded using nasopharyngeal swab tests.

A, PET maximum intensity projection image shows a fluorine 18 fluorodeoxyglucose (FDG)–avid mass (arrow) with a maximum standardized uptake value of 4.9 in the right lung. Increased accumulation of FDG in the right paratracheal, right hilar lymph nodes (arrowheads), and bone marrow are also noted. B, Low-dose axial CT scan and, C, PET/CT fusion image show ground-glass opacities with areas of focal consolidation (black arrow) primarily in the right upper lobe and a focal opacity in the left upper and right middle lobes (white arrows). D, Follow-up CT scan obtained 4 days later demonstrates progression of lesions in bilateral upper and right middle lobes (arrows) with newly developed focal opacities in the left upper and lower lobes (arrows). Download as PowerPointOpen in Image Viewer

Follow-up CT 4 days later revealed progression of lesions in the bilateral upper and middle lobes with newly developed focal opacities in the left upper and lower lobes (Figure, part D) (1,2). One week later, severe acute respiratory syndrome coronavirus 2 infection was confirmed by means of real-time fluorescence polymerase chain reaction confirming coronavirus disease 2019 (COVID-19). After 10 days of treatment, the patient was considered recovered from COVID-19 and was discharged.

Supported by the National Natural Science Foundation of China (grants 91959119, 81873903, and 81671718) and the Clinical Foundation of Tongji Hospital (grant 2015C013).

References 1. Kanne JP , Little BP , Chung JH , Elicker BM , Ketai LH . Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel . Radiology 2020 ;296:E113–E114. Google Scholar ;296:E113–E114. Abstract

2. Ai T , Yang Z , Hou H et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases . Radiology 2020 ; 296:E32–E40. Google Scholar ; 296:E32–E40. Abstract

disclosed no relevant relationships.disclosed no relevant relationships.