CTICasesEndobronchial Metastasis from Renal Cell Carcinoma causing Right Middle and Lower Lobe Atelectasis
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Imaging findings
Coronal CT reconstructions and scout images demonstrate combined right middle and lower lobe atelectasis, characterized by a depressed minor fissure and a depressed major fissure. Contrast-enhanced chest CT shows extensive mediastinal lymphadenopathy and a soft tissue mass within the bronchus intermedius, completely obstructing the right middle and lower lobe bronchi.
Key takeaways
Endobronchial metastasis is an uncommon presentation of extrapulmonary malignancies, with renal cell carcinoma, breast cancer, colorectal cancer, and melanoma being among the most frequent primary sources. Obstructive lesions in the bronchus intermedius cause a combined collapse of the right middle and lower lobes, which displays characteristic pleural and fissural interfaces that can easily be mistaken for a single large, parenchymal mass on chest radiographs.
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