Foreign Body Granuloma

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FDG is a non-physiological analogue of glucose that once injected, is taken up by cell membrane glucose receptors (Mainly, the glucose transporter-1 molecule, GLUT-1) which transport it into the intracellular compartment, where it is phosphorylated into FDG-6-phosphate by the enzymatic action of hexokinase. Cancer cells show increased uptake of glucose (due to an overexpression of glucose transporter proteins) and increased rate of glycolysis. However, following phosphorylation by hexokinase, FDG becomes trapped in the cancer cell, failing to undergo further metabolism due to down-regulation of phosphatase [1] .

Inflammation is the primary response of the lung immune system to infection or irritation like an occult foreign body. Activated
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This reaction is characterized by neutrophils and activated macrophages migration to the host-foreign body and if the foreign body cannot be degraded, macrophages fuse together forming foreign body giant cells (FBGCs) and foreign body granuloma. FBGCs have an enhanced hyper-metabolic state resulting in an increased localized uptake of FDG causing false positive PET/CT…show more content…
One was an abstract that described increased FDG due to impacted foreign body that was subsequently removed through bronchoscopy and was proven to be a fishbone [19]. Patient was 62-years old and presented with recurrent cough. The second case described PET/CT positive right lung nodules in a patient with history of left lung cancer post resection [20]. A biopsy was performed which confirmed the nodule to be a granuloma with foreign body giant cells and debris of calcifications. Patient was 49-years old and asymptomatic at the time of presentation. In our case, patient presented with hemoptysis and was only 25 years at the time of
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