CTICasesMetastatic Renal Cell Carcinoma
Imaging findings
Frontal and lateral chest radiographs demonstrate multiple subtle, bilateral pulmonary nodules that are difficult to visualize on projectional radiography but are clearly apparent on CT. Biopsy of these nodules confirmed metastatic renal cell carcinoma.
Key takeaways
Projectional chest radiography has limited sensitivity for detecting small or low-density pulmonary nodules, demonstrating a well-known perceptual challenge where multiple nodules can be obscured by overlying bony structures, mediastinal shadows, or breathing motion. Metastatic renal cell carcinoma typically presents as multiple well-circumscribed 'cannonball' nodules of varying sizes in the lungs.
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