Lung is a common site for metastasis from malignancies from other organs.
- Lung is a capillary bed and the entire cardiac output
passes through it, thus it is no surprise tumors get trapped in lungs.
- Various patterns of metastasis should be recognized. Common patterns are
Mode of clinical presentation varies depending on the pattern of metastasis.
- Asymptomatic, detected on routine CXR.
- Cough, hemoptysis, pneumonia, wheezing with endobronchial mets.
- Shortness of breath, cough with lymphatic spread.
- Pleuritic pain, cough and shortness of breath with pleural effusions.
Again depends on the metastatic pattern.
- FNAB for solitary or multiple lung mets.
- Sputum cytology and bronchoscopy for endobronchial mets.
- Pleural fluid cytology for effusions.
- Tranbronchial lung biopsy for lymphatic spread.
Very important treatment issues revolve around the presence and pattern of
- Lung metastasis most often would preclude a surgical curative resection
of the primary.
- Surgical resection of a solitary lung metastasis along with
resection of the primary can accomplish cure in certain tumors.
- Brachytherapy therapy may be useful to relieve symptoms with
- Pleural sclerosis is necessary in pleural effusions.
- Certain chemotherapeutic agents can sequester in effusions.