CTICasesIntravascular Pulmonary Metastases from Colon Cancer
Imaging findings
High-resolution chest CT demonstrates a subtle, knobby, and beaded appearance of the peripheral pulmonary vasculature in both lower lobes. On maximum intensity projection (MIP) reconstructions, these vessels are seen as dilated, tortuous, and beaded structures representing tumor thrombi within the subsegmental and lobular arterioles in a patient with metastatic colon cancer.
Key takeaways
Intravascular pulmonary metastases (tumor embolism) occur when tumor cells embolize and proliferate within the pulmonary arterioles, which can lead to tumor thrombotic microangiopathy (PTTM) and pulmonary hypertension. It typically arises from mucin-producing adenocarcinomas (such as breast, stomach, or colon cancer). On CT, it presents with a distinctive 'knobby' or beaded vascular appearance that is best appreciated on MIP reconstructions.
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