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Vascular Invasion
Florian J. Fintelmann, MD, FRCPC; Gerald F. Abbott, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Tumor/tumor cells in blood vessel wall &/or lumen
              • Pulmonary vessels
                • Pulmonary artery(ies)/vein(s)
              • Systemic vessels
                • Vena cava
                • Azygos/hemiazygos venous systems
                • Aorta
                • Great arteries: Brachiocephalic, left common carotid, left subclavian, and vertebral
            • Types of vascular invasion
              • Microscopic
                • Diagnosed on histopathologic analysis
              • Macroscopic
                • Imaging documentation of vascular involvement on CT, MR, or angiography
                  • Endovascular filling defect contiguous with tumor
                  • Vascular encasement &/or stenosis by tumor
                  • Obliteration of vascular lumen by tumor

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Mollberg NM et al: Lymphovascular invasion as a prognostic indicator in stage I non-small cell lung cancer: a systematic review and meta-analysis. Ann Thorac Surg. 97(3):965-71, 2014
                                          2. Detterbeck FC et al: The stage classification of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 143(5 Suppl):e191S-210S, 2013
                                          3. Tsujimoto H et al: Distance between the esophageal tumor and the aorta measured by using the contrast-enhanced attenuation on computed tomography for predicting this tumor invading aorta. J Gastroenterol Hepatol. 28(2):297-302, 2013
                                          4. Benveniste MF et al: Role of imaging in the diagnosis, staging, and treatment of thymoma. Radiographics. 31(7):1847-61; discussion 1861-3, 2011
                                          5. Hoffmann RT et al: Lung bleeding caused by tumoral infiltration into the pulmonary artery--minimally invasive repair using microcoils. Cardiovasc Intervent Radiol. 30(6):1282-5, 2007
                                          6. Agarwal PP et al: Pulmonary artery pseudoaneurysm secondary to metastatic angiosarcoma. Thorax. 61(4):366, 2006
                                          7. Sakuma M et al: Cancer and pulmonary embolism: thrombotic embolism, tumor embolism, and tumor invasion into a large vein. Circ J. 70(6):744-9, 2006
                                          8. DiPerna CA et al: Surgical management of T3 and T4 lung cancer. Clin Cancer Res. 11(13 Pt 2):5038s-5044s, 2005
                                          9. Jeong YJ et al: Does CT of thymic epithelial tumors enable us to differentiate histologic subtypes and predict prognosis? AJR Am J Roentgenol. 183(2):283-9, 2004
                                          10. Picus D et al: Computed tomography in the staging of esophageal carcinoma. Radiology. 146(2):433-8, 1983
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Tumor/tumor cells in blood vessel wall &/or lumen
                                                      • Pulmonary vessels
                                                        • Pulmonary artery(ies)/vein(s)
                                                      • Systemic vessels
                                                        • Vena cava
                                                        • Azygos/hemiazygos venous systems
                                                        • Aorta
                                                        • Great arteries: Brachiocephalic, left common carotid, left subclavian, and vertebral
                                                    • Types of vascular invasion
                                                      • Microscopic
                                                        • Diagnosed on histopathologic analysis
                                                      • Macroscopic
                                                        • Imaging documentation of vascular involvement on CT, MR, or angiography
                                                          • Endovascular filling defect contiguous with tumor
                                                          • Vascular encasement &/or stenosis by tumor
                                                          • Obliteration of vascular lumen by tumor

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Angiographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Mollberg NM et al: Lymphovascular invasion as a prognostic indicator in stage I non-small cell lung cancer: a systematic review and meta-analysis. Ann Thorac Surg. 97(3):965-71, 2014
                                                                                  2. Detterbeck FC et al: The stage classification of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 143(5 Suppl):e191S-210S, 2013
                                                                                  3. Tsujimoto H et al: Distance between the esophageal tumor and the aorta measured by using the contrast-enhanced attenuation on computed tomography for predicting this tumor invading aorta. J Gastroenterol Hepatol. 28(2):297-302, 2013
                                                                                  4. Benveniste MF et al: Role of imaging in the diagnosis, staging, and treatment of thymoma. Radiographics. 31(7):1847-61; discussion 1861-3, 2011
                                                                                  5. Hoffmann RT et al: Lung bleeding caused by tumoral infiltration into the pulmonary artery--minimally invasive repair using microcoils. Cardiovasc Intervent Radiol. 30(6):1282-5, 2007
                                                                                  6. Agarwal PP et al: Pulmonary artery pseudoaneurysm secondary to metastatic angiosarcoma. Thorax. 61(4):366, 2006
                                                                                  7. Sakuma M et al: Cancer and pulmonary embolism: thrombotic embolism, tumor embolism, and tumor invasion into a large vein. Circ J. 70(6):744-9, 2006
                                                                                  8. DiPerna CA et al: Surgical management of T3 and T4 lung cancer. Clin Cancer Res. 11(13 Pt 2):5038s-5044s, 2005
                                                                                  9. Jeong YJ et al: Does CT of thymic epithelial tumors enable us to differentiate histologic subtypes and predict prognosis? AJR Am J Roentgenol. 183(2):283-9, 2004
                                                                                  10. Picus D et al: Computed tomography in the staging of esophageal carcinoma. Radiology. 146(2):433-8, 1983