Presentation
Cough, hemoptysis and chest pain,
Patient Data
Age: 65 years
Gender: Male
From the case:
Metastasizing bronchogenic carcinoma
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- A relatively large left lung lingular lobe irregular and spiculated heterogeneously enhancing and necrotic mass lesion is seen measuring 9.5 X 5 X 4.5 cm. The lesion is seen abutting and possibly invading the related pleura.
- Enlarged mediastinal lymph nodes, mainly the pre-vascular, aorto-pulmonary, right para-tracheal (retro-caval) as well as pre-carinal and sub-carinal lymph nodes are seen with similar heterogenous enhancement, the largest is 2 X 2.5 cm.
- Enlarged heterogenous enhancing left hilar lymph node is seen measuring 3 X 3 cm.
- Emphysematous changes of both lungs with hyperinflation and small bilateral sub-pleural cysts (emphysematous bullae).
- No right lung masses.
- Mild pericardial effusion. No gross cardiomegaly.
- The scanned upper abdomen shows:
- Bilateral heterogeneously enhancing adrenal masses with the largest right adrenal mass is about 4.8 X 4.4 X 4 cm, the left adrenal mass lesion measures about 2.5 X 2 cm.
- Few heterogeneous, mainly marginally enhancing hepatic lesions with the largest is 3 X 3 cm.
- The scanned bony spine and ribs show multiple osteolytic lesions as well as small old fracture of lateral aspect of the left 8th rib.
Case Discussion
Left lung lingular irregular and spiculated heterogenously enhancing malignant mass lesion (bronchogenic carcinoma) with metastatic mediastinal and left hilar lymphadenopathy as well as hepatic, bilateral adrenal and bony metastatic deposits.
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