The incidental lung lesion: effect of cardiac stress on the MIBI uptake in the lung mass

A discrete MIBI avid lung lesion was found in cinematic views of myocardial perfusion imaging (MPI) of a 59 year-old woman. Interestingly, the abnormal uptake in the lung was detectable only in the rest phase images and not in the images acquired in the stress phase. MPI was performed for pre-operation cardiac risk assessment before correction surgery for spinal canal stenosis.  She had no past medical history or symptoms concerning pulmonary problems. The clinical examination of the pulmonary system was normal. MPI was reported normal but for the lung lesion she was sent for consultation with pulmonologist. The pulmonologist diagnosed the lesion was an old inflammatory/infective lesion probably secondary to tuberculosis. No histopathological examination was done. By reporting this case we intended to highlight the possibility of the effect of stress on uptake of MIBI in tumoral lesions as a tumor agent in nuclear medicine.