Diagnosis of Pneumothorax on F-18 FDG PET After Transbronchial Biopsy

Transbronchial lung biopsy (TBLB) is associated with pneumothorax, 12% occurring 1 to 4 hours postprocedure (delayed pneumothorax). We report a case of a delayed pneumothorax first diagnosed on a positron emission tomography (PET) scan performed 5 days after TBLB. An early post-TBLB chest radiograph (after 1 hour) had not demonstrated any pneumothorax. The delayed pneumothorax was later confirmed with a repeat radiograph after the PET scan. Often, PET is performed to diagnose or stage pulmonary lesions after TBLB rather than before. Therefore, nuclear physicians must remain vigilant to recognize subtle pneumothoraces on PET scans.