Pulmonary metastases are common showing high prevalence in patients with extrathoracic malignancies and a figure of 20-54% is mentioned according to an autopsy study . As many as 90% of patients with lung metastases have a known extrathoracic primary tumor or symptoms of a synchronous primary tumor and chest symptoms are usually absent in patients with multiple metastases (80-95%).
AIM OF STUDY:
To elucidate the most common findings detected by chest CT in patients with pulmonary metastases, to be familiar with in the management & follow-up of these patients.
The study was conducted on forty-two patients with definite primary extrathoracic malignancies by chest spiral CT(SOMATOM PLUS 4 by Siemens medical systems), those with multiple pulmonary metastatic nodules were selected. Data were collected regarding CT characteristics of the pulmonary nodules and the extraparenchymal chest lesions involving the pleura, lymph nodes and of chest wall bones.
The forty-two patients (twenty-seven females and fifteen males), 81% of them were above forty years. The most common (59.5%) primary tumor was breast carcinoma .All patients had pulmonary nodules enhancing more than 20 Hounsfield units (HU) and (59.5%) of them showed nodule enhancements ranging from 30HU to 50HU.Cavitatng and calcified pulmonary nodules were seen in 9.5% and 2.4% of all patients respectively. Extraparenchymal chest lesions were found collectively in 33.3% of all patients, the most common finding of which were pleural effusion and intrathoracic lymphadenopathy (14.2% and 9.5% respectively), while bone metastases was shown in 7.1% of patients.
We concluded that the most common findings detected by chest CT in patients with pulmonary metastases are the enhancing nodules with enhancements of more than 20 Hounsfield units & the extra-parenchymal chest lesions, while other findings like cavitation and calcification are unusual and occur with certain primary tumors