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A 60-year-old man with a history of left lung bronchogenic carcinoma, prior left pneumectomy 5 years previously, presented with cough and weight loss. A restaging FDG-PET/CT study to evaluate for recurrent disease demonstrated intense FDG avidity in a large right upper lobe mass (arrows) and in metastatic mediastinal lymph nodes. The study also revealed an intensely FDG avid soft tissue mass associated with a destructive L5 spinous process consistent with metastatic deposit (arrow).
