CTICasesMetastatic Cholangiocarcinoma with Consolidative/Lepidic Growth Pattern
Imaging findings
Chest computed tomography demonstrates widespread, dense consolidative opacities primarily in the lower lobes, mimicking multifocal pneumonia, alongside numerous bilateral pulmonary nodules. A CT-guided biopsy reveals metastatic adenocarcinoma with prominent mucin production, infiltrating along alveolar walls in a pattern simulating lepidic growth.
Key takeaways
Metastatic mucinous adenocarcinomas, particularly from pancreaticobiliary or biliary tract primary malignancies, can present as consolidative lung opacities on CT. This appearance results from tumor cells utilizing the alveolar scaffold to grow in a pseudo-lepidic fashion, which can mimic infectious pneumonia or primary lung adenocarcinoma.
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