Correct!

Answer: 6. More than one of the above

Endobronchial ultrasound with fine needle aspiration biopsy, endoscopic ultrasound with fine needle aspiration biopsy, left anterior medastinotomy (Chamberlain procedure), and potentially extended cervical mediastinoscopy could access this lesion to establish a histopathological diagnosis. Because this lesion resides lateral to the ligamentum arteriosum, standard cervical mediastinoscopy cannot access this lesion.)

Two months after the thoracic CT, the patient subsequently underwent left anterior medastinotomy to establish the etiology of the subaortic lesion.The diagnosis: was a large cell neuroendocrine tumor

One month following the thoracotomy, the patient underwent 2-[18F]-Fluoro-2-Deoxy-D-Glucose positron emission computed tomography-CT (FDG-PET CT) for staging purposes.

Figure 3:  FDG-PET CT.

Which of the following statements is correct?   

1. FDG-PET CT shows increased metabolic activity in the subaortic space and anterior chest wall and left internal mammary region, suggesting metastatic malignancy
2. FDG-PET CT shows only increased metabolic activity in the subaortic space, corresponding to the large cell neuroendocrine tumor in this region
3. FDG-PET CT shows only normal myocardial tracer utilization
4. FDG-PET CT shows increased metabolic activity in the subaortic space  and activity in the left chest wall, most likely related to the recent thoracotomy
5. FDG-PET CT shows elevated tracer utilization that localizes to the lumen of the left pulmonary artery, suggesting pulmonary embolism

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