CTICasesInfectious Bronchiolitis mimicking Metastatic Thyroid Cancer
Imaging findings
An I-131 whole-body scan in a patient with Hürthle cell thyroid cancer shows abnormal radioiodine uptake in the right upper lobe. Chest CT demonstrates tree-in-bud nodules, bronchial wall thickening, and mucus plugging (debris in the airways) in the right upper lobe, consistent with infectious bronchiolitis.
Key takeaways
Radioactive iodine (I-131) is used to detect and treat thyroid cancer metastases, but false-positive uptake can occur in areas of active infection or inflammation due to increased perfusion and capillary permeability. Common causes of false-positive lung uptake include bronchiectasis, active pneumonia, and infectious bronchiolitis (e.g., due to Mycobacterium avium complex or other bacteria).
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