CTICasesPulmonary Tumor Embolism
Imaging findings
CTA of the chest in a patient with metastatic renal cell carcinoma shows diffuse, bilateral, and tortuous branching intravascular densities within the segmental and subsegmental pulmonary arteries and veins, mimicking small airway mucus impaction. There is a large primary renal mass and necrotic mediastinal adenopathy.
Key takeaways
Pulmonary tumor embolism is a form of metastatic disease where neoplastic cells (classically renal cell carcinoma, hepatocellular carcinoma, or breast cancer) proliferate within the lumen of the pulmonary vessels. On CT, this can mimic small airway disease (tree-in-bud), but the vascular location and associated primary tumor are key clues. Bronchoscopy is negative because the tumor is endovascular.
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Related Neoplastic cases
- Renal Cell Carcinoma with Intravascular Metastatic Spread
- Mediastinal Germ Cell Tumor (Yolk Sac Tumor / Mature Teratoma After Treatment)
- Tracheobronchial Dissemination of Carcinoid Tumor
- NUT Carcinoma (Midline NUT Carcinoma)
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- Ciliated Muconodular Papillary Tumor (CMPT) of the Lung