CTICasesAdenoid Cystic Carcinoma Pulmonary Metastases with Target Ring Appearance
Imaging findings
CT in a woman with prior head and neck adenoid cystic carcinoma demonstrates multiple bilateral pulmonary nodules with a striking morphology: several nodules show a target-like or double-ring appearance with concentric rims of soft tissue attenuation surrounding a central soft tissue core, distinct from the subsolid nodules seen on the prior PET-CT two years earlier, which have slowly enlarged over the interval.
Key takeaways
Adenoid cystic carcinoma (ACC) is a salivary gland-type malignancy notorious for late and indolent pulmonary metastases that may not be FDG-avid on PET and grow over years to decades. Pulmonary metastases from ACC can have an unusual spoke-wheel or target ring morphology that should be distinguished from primary pulmonary adenocarcinoma. When multiple slow-growing pulmonary nodules with unusual morphology are encountered in a patient with head and neck ACC, metastatic disease should take priority in the differential.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Intra-Aortic Balloon Pump via Axillary ApproachIatrogenic
- Cardiac Lymphoma (Secondary) with Pericardial EffusionNeoplastic
- Primary Mediastinal Non-Hodgkin Lymphoma (Subtle Initial Radiograph)Neoplastic
- Subcarinal Infected (or Inflamed) Bronchogenic CystCongenital
- Bartonella quintana Endocarditis with Aortic Root PseudoaneurysmInfection
- Pleuropulmonary Blastoma Type 1r (Regressed) with DICER1 SyndromeNeoplastic
- Pulmonary AL Amyloidosis with Cystic Lung Disease and Thin-Wall BronchiectasisMetabolic
- Radiation Fibrosis with Comet Tail SignIatrogenic
See all cases from February 20, 2021 →
Related Neoplastic cases
- Panniculitis-like T-cell Lymphoma (Subcutaneous T-cell Lymphoma)
- Erdheim-Chester Disease with Peri-Renal and Mediastinal Infiltration
- Small Cell Carcinoma Presenting with Bulky Mediastinal Lymphadenopathy
- Esophageal Intramural Lipoma
- Diffuse Idiopathic Pulmonary Neuroendocrine Cell Hyperplasia (DIPNECH) with Carcinoid Tumorlets
- Multiple Elastofibromas (including Elastofibroma Dorsi)