Fig. 6
69-year-old man with prior melanoma of the right forearm, 2.1 mm Breslow-depth without ulceration and 1/mm2 mitoses and positive axillary sentinel lymph node (0.2 mm focus with no extracapsular extension) with no adjuvant therapy on observation. Panel A displays surveillance 18F-FDG PET MIP 5 months post-resection of the primary lesion. A new FDG-avid nodule was noted in the left lower lobe (panel B and C) which due to respiratory movement appeared ill-defined. A dedicated CT of the chest 7 days later confirmed the nodule in the left lower lobe (panel D) and also showed an additional nodule in the right lower lobe (panel G) which went undetected on the PET/CT (panel E and F) and were suspicious for metastatic melanoma. Wedge resection of the left lower lobe revealed caseation granuloma and the patient continued on surveillance