Bloodborne spread of cancer cells to lung (primary filtration organ)
Tumorlets may form within pulmonary arteries, interstitium, lymphatics, airways, pleura, lymph nodes
IMAGING
General Features
Radiographic Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Frazier AA et al: A spectrum of metastatic disease in the chest: insights for the radiologist. Semin Roentgenol. 55(1):51-9, 2020
Hang TX et al: Misdiagnosis of a multi-organ involvement hematogenous disseminated tuberculosis as metastasis: a case report and literature review. Infect Dis Poverty. 9(1):66, 2020
Altorki NK et al: The lung microenvironment: an important regulator of tumour growth and metastasis. Nat Rev Cancer. 19(1):9-31, 2019
Deniffel D et al: Differentiating intrapulmonary metastases from different primary tumors via quantitative dual-energy CT based iodine concentration and conventional CT attenuation. Eur J Radiol. 111:6-13, 2019
Iftikhar A et al: Sarcoid-like reaction associated with renal cell carcinoma - a case report. Respir Med Case Rep. 27:100847, 2019
Kaneko Y et al: Hilar and mediastinal sarcoid-like reaction after the treatment of malignant tumors: imaging features and natural course on 18F-FDG-PET/CT. Jpn J Radiol. 37(1):88-94, 2019
Stowell JT et al: Thoracic manifestations of genitourinary neoplasms and treatment-related complications. J Thorac Imaging. 34(3):W36-48, 2019
Bois MC et al: Neoplastic embolization to systemic and pulmonary arteries. J Vasc Surg. 68(1):204-12.e7, 2018
Payá-Llorente C et al: Mediastinal sarcoid-like reaction in cancer patients. Pulmonology. 24(1):61-3, 2018
Paku S et al: The evidence for and against different modes of tumour cell extravasation in the lung: diapedesis, capillary destruction, necroptosis, and endothelialization. J Pathol. 241(4):441-7, 2017
Shroff GS et al: Imaging of metastases in the chest: mechanisms of spread and potential pitfalls. Semin Ultrasound CT MR. 38(6):594-603, 2017
Holwerda RA et al: Thoracic metastases from primary hepatobiliary and pancreatic malignancies: predictable patterns of metastatic spread. J Thorac Imaging. 30(6):W82-91, 2015
Paño B et al: Pathways of lymphatic spread in gynecologic malignancies. Radiographics. 35(3):916-45, 2015
Hasleton P: Metastases involving the lungs. In Spencer's Pathology of the Lung. Cambridge University Press. 6th ed. 1375-407, 2013
Martínez-Jiménez S et al: Imaging features of thoracic metastases from gynecologic neoplasms. Radiographics. 34(6):1742-54, 2014
Brufau BP et al: Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics. 33(6):1691-716, 2013
Eckardt J et al: Thoracoscopic versus open pulmonary metastasectomy: a prospective, sequentially controlled study. Chest. 142(6):1598-602, 2012
Aquino SL: Imaging of metastatic disease to the thorax. Radiol Clin North Am. 43(3):481-95, vii, 2005
Seo JB et al: Atypical pulmonary metastases: spectrum of radiologic findings. Radiographics. 21(2):403-17, 2001
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
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Diagnostic Checklist
TERMINOLOGY
Definitions
Bloodborne spread of cancer cells to lung (primary filtration organ)
Tumorlets may form within pulmonary arteries, interstitium, lymphatics, airways, pleura, lymph nodes
IMAGING
General Features
Radiographic Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Frazier AA et al: A spectrum of metastatic disease in the chest: insights for the radiologist. Semin Roentgenol. 55(1):51-9, 2020
Hang TX et al: Misdiagnosis of a multi-organ involvement hematogenous disseminated tuberculosis as metastasis: a case report and literature review. Infect Dis Poverty. 9(1):66, 2020
Altorki NK et al: The lung microenvironment: an important regulator of tumour growth and metastasis. Nat Rev Cancer. 19(1):9-31, 2019
Deniffel D et al: Differentiating intrapulmonary metastases from different primary tumors via quantitative dual-energy CT based iodine concentration and conventional CT attenuation. Eur J Radiol. 111:6-13, 2019
Iftikhar A et al: Sarcoid-like reaction associated with renal cell carcinoma - a case report. Respir Med Case Rep. 27:100847, 2019
Kaneko Y et al: Hilar and mediastinal sarcoid-like reaction after the treatment of malignant tumors: imaging features and natural course on 18F-FDG-PET/CT. Jpn J Radiol. 37(1):88-94, 2019
Stowell JT et al: Thoracic manifestations of genitourinary neoplasms and treatment-related complications. J Thorac Imaging. 34(3):W36-48, 2019
Bois MC et al: Neoplastic embolization to systemic and pulmonary arteries. J Vasc Surg. 68(1):204-12.e7, 2018
Payá-Llorente C et al: Mediastinal sarcoid-like reaction in cancer patients. Pulmonology. 24(1):61-3, 2018
Paku S et al: The evidence for and against different modes of tumour cell extravasation in the lung: diapedesis, capillary destruction, necroptosis, and endothelialization. J Pathol. 241(4):441-7, 2017
Shroff GS et al: Imaging of metastases in the chest: mechanisms of spread and potential pitfalls. Semin Ultrasound CT MR. 38(6):594-603, 2017
Holwerda RA et al: Thoracic metastases from primary hepatobiliary and pancreatic malignancies: predictable patterns of metastatic spread. J Thorac Imaging. 30(6):W82-91, 2015
Paño B et al: Pathways of lymphatic spread in gynecologic malignancies. Radiographics. 35(3):916-45, 2015
Hasleton P: Metastases involving the lungs. In Spencer's Pathology of the Lung. Cambridge University Press. 6th ed. 1375-407, 2013
Martínez-Jiménez S et al: Imaging features of thoracic metastases from gynecologic neoplasms. Radiographics. 34(6):1742-54, 2014
Brufau BP et al: Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics. 33(6):1691-716, 2013
Eckardt J et al: Thoracoscopic versus open pulmonary metastasectomy: a prospective, sequentially controlled study. Chest. 142(6):1598-602, 2012
Aquino SL: Imaging of metastatic disease to the thorax. Radiol Clin North Am. 43(3):481-95, vii, 2005
Seo JB et al: Atypical pulmonary metastases: spectrum of radiologic findings. Radiographics. 21(2):403-17, 2001
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