Amiodarone - induced pulmonary nodules mimiking metastatic lung disease - investigation by somatostatin radio peptide scanning.

A 61 year old former paramedic presented to A&E complaining of palpitations. He was found to be in atrial fibrillation, which reverted spontaneously to sinus rhythm. A chest x-ray taken at that time showed multiple pulmonary nodules consistent with metastatic malignancy (Figure 1). In the past he had been treated with amiodarone 200mg daily for 6 years following a previous diagnosis of atrial fibrillation, which had been attributed to alcoholic cardiomyopathy. He had discontinued the drug 8 months earlier, after self diagnosing hypotension and bradycardia. A previous chest x-ray, taken before starting amiodarone, was normal.