CTICasesMetastatic Pancreatic Adenocarcinoma
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Imaging findings
High-resolution CT shows progressive, bilateral, symmetric, peripheral-predominant ground-glass opacities, consolidation, and multiple cavitary and pseudo-cavitary nodules resembling organizing pneumonia or granulomatosis with polyangiitis (GPA). Contrast-enhanced abdominal CT demonstrates a subtle, hypodense mass in the body/tail of the pancreas.
Key takeaways
Metastasizing malignancies, particularly pancreatic adenocarcinoma and hepatocellular carcinoma, can atypical-looking hematogenous metastases that mimic benign inflammatory conditions like organizing pneumonia or vasculitis. When encountering unexplained, peripheral-predominant cavitary or ground-glass lung nodules, a careful evaluation of the upper abdomen to rule out an occult primary GI malignancy is always warranted.
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