Uncommon thoracic manifestations from extrapulmonary tumors: Computed tomography evaluation - Pictorial review

Respir Med. 2020 Jul:168:105986. doi: 10.1016/j.rmed.2020.105986. Epub 2020 Apr 28.


Although metastasis can occur at a variety of sites, pulmonary involvement is common in patients with cancer. Depending on the source and type of tumor, pulmonary metastases present with a wide range of radiologic appearances. Hematogenous dissemination through the pulmonary arteries to the pulmonary capillary network is the most common form of spread in pulmonary metastases. However, they may also reach the lung via lymphatic dissemination, secondary airway involvement, vessel tumor embolism, and direct chest invasion. In the evaluation of patients with known extrathoracic tumors, CT is the state-of-the-art imaging modality for detecting and characterize pulmonary metastases as well as to predict resectability. Although CT limitations are well known, knowledge of growth rates of various tumors and understanding the pattern of spread may be helpful clues in suggesting and even establish the specific diagnosis. The purpose of this pictorial review is to discuss the imaging appearances of different patterns of intrathoracic tumoral dissemination.

Keywords: Computed tomography; Extrapulmonary tumors; Pulmonary diseases; Pulmonary tumors.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Lung Neoplasms / blood supply
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / secondary*
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neoplastic Cells, Circulating
  • Pulmonary Artery / diagnostic imaging
  • Tomography, X-Ray Computed / methods*