1. Detection of an Asymptomatic Right-Ventricle Cardiac Metastasis from a Small-Cell Lung Cancer by F-18-FDG PET/CT 
Maria Victoria Orcurto, MD, Angelika Bischof Delaloye, MD, Igor Letovanec, MD, Martina Martins Favre, MD, John O. Prior, MD, PhD 
Journal of Thoracic Oncology 
Volume 4, Issue 1, Pages (January 2009)
DOI: /JTO.0b013e318189f60e
Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

2. FIGURE 1
Maximal intensity projection image (MIP) of: A, pretherapeutic positron emission tomography/computed tomography (PET/CT) showing increased uptake of 18F-fluorodeoxyglucose (FDG) in the large lung tumor of the upper right lobe (*) with central necrosis (standardized uptake value [SUVmax] from 15 to 25 g/ml). Note also a high uptake in the right hilar and mediastinal lymph nodes. Focal increased uptake is visualized in the right ventricle corresponding to the heart metastasis confirmed later (arrow). B, Follow-up PET/CT several weeks after chemo-radiotherapy. The cardiac lesion (arrow) as well as mediastinal and hilar lymph nodes show no longer increased tracer uptake while the residual lung tumor still accumulates 18F-FDG (SUVmax 20 g/ml).
Journal of Thoracic Oncology 2009 4, DOI: ( /JTO.0b013e318189f60e)
Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

3. FIGURE 2
A, Transaxial images of the pretherapeutic computed tomography (CT), positron emission tomography (PET)/CT fusion and PET showing the cardiac metastasis appearing as a focal 18F-FDG uptake in the right ventricle (SUVmax 13 g/ml) and a hypodense area on native CT (arrow). B, On the posttherapy PET/CT the cardiac metastasis is no longer visible.
Journal of Thoracic Oncology 2009 4, DOI: ( /JTO.0b013e318189f60e)
Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

4. FIGURE 3
Ventriculography performed during right ventricle catheterization showing an apical mass molded by the contrast agent (arrow).
Journal of Thoracic Oncology 2009 4, DOI: ( /JTO.0b013e318189f60e)
Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions

5. FIGURE 4
H&E staining of the endomyocardial biopsy (40×, insert 200×): fragments of myocardium and groups of densely packed small tumoral cells can be seen; the insert is detailing scant cytoplasm, finely granular nuclear chromatin, nuclear molding, absent nucleoli and extensive necrosis. Immunostaining (not shown) revealed positive cytoplasmic markers for a tumor of neuroendocrine origin (synaptophysin+, chromogranin+ and CD56+).
Journal of Thoracic Oncology 2009 4, DOI: ( /JTO.0b013e318189f60e)
Copyright © 2009 International Association for the Study of Lung Cancer Terms and Conditions