Pulmonary metastases in neuroblastoma.

Manifestations of pulmonary metastases were reviewed in a retrospective study of 30 patients with the autopsy diagnosis of neuroblastoma seen over a 25 year period. Seven patients with histologic evidence of pulmonary metastases are reported. Radiologic manifestations included examples of direct extension, hematogenous spread, and lymphangitic spread. Two patients with lymphangitic pulmonary metastases had clinically significant respiratory distress. Pulmonary spread in neuroblastoma represents widely disseminated metastatic diseases and is a grave prognostic sign.