Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain.
Saint Luke's Hospital of Kansas City, University of Missouri in Kansas City, 4401 Wornall Rd, Kansas City, USA.
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.
虽然转移可以发生在多种部位，但癌症患者常伴有肺部受累。根据肿瘤的来源和类型，肺转移表现出广泛的影像学表现。通过肺动脉向肺毛细血管网的血行播散是肺转移最常见的播散形式。然而，它们也可能通过淋巴扩散、次级气道受累、血管肿瘤栓塞和直接胸部侵犯到达肺部。在评估已知胸外肿瘤的患者时，CT 是检测和特征化肺转移以及预测可切除性的最先进的成像方式。尽管 CT 的局限性众所周知，但了解各种肿瘤的生长速度和理解播散模式可能有助于提示甚至确定特定的诊断。本影像学综述的目的是讨论不同类型的胸内肿瘤播散的影像学表现。
