CTICasesFocal Organizing Pneumonia from Aspiration Mimicking Malignancy
Imaging findings
CT demonstrates a rapidly growing pulmonary nodule with slightly ill-defined margins that significantly increased in size over a short 21-day interval. FDG-PET scan shows very low metabolic activity with an SUV of approximately 1.x, and the calculated volume doubling time of the lesion is extraordinarily rapid at 11 days.
Key takeaways
Histological evaluation of the resected nodule revealed organizing pneumonia with features suggestive of aspiration. Organizing pneumonia can present as solitary or multiple nodules that mimic metastases or primary lung cancer. A very short doubling time (such as 11 days) and low FDG avidity are highly characteristic of benign, active inflammatory or infectious processes rather than malignancy, highlighting the utility of short-term follow-up rather than immediate surgical resection in such cases.
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