CTICasesMAC Infection in Metastatic Colon Cancer Cavitation
Imaging findings
CT chest in a patient with metastatic colon cancer shows complex cavitation within a metastatic nodule. Over time, the cavity shows wall thickening and the development of multiple new, small centrilobular nodules. Cultures grew Mycobacterium avium complex (MAC).
Key takeaways
Necrotic or cavitated metastatic lung nodules can become secondarily infected with opportunistic pathogens like MAC. The development of new centrilobular nodules surrounding a cavitating metastasis is a clue for infectious spillage (bronchogenic spread of mycobacteria) rather than tumor progression.
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