CTICasesSpontaneous Pneumothorax with Pleural Metastases from Lung Cancer
Imaging findings
An older male smoker presented with a spontaneous pneumothorax and collapsed right lung, requiring pigtail catheter placement. Imaging revealed diffuse nodular thickening and studding of the pleura on the affected side, with at least two discrete lung masses. Thoracoscopic surgery confirmed pleural metastases from his lung cancer.
Key takeaways
Spontaneous pneumothorax in an older smoker with underlying lung masses should raise strong suspicion for malignant pleural disease. Diffuse pleural nodularity or studding in such a context is indicative of M1a disease (pleural metastases) from lung cancer. This can lead to pneumothorax due to rupture of subpleural lesions or direct pleural involvement by the disseminated tumor.
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