CTICasesPerilymphatic Pulmonary Metastases
Imaging findings
CT chest shows bilateral, small nodular opacities distributed along the subpleural surfaces, interlobular septa, and bronchovascular bundles (perilymphatic pattern), mimicking sarcoidosis. Tissue pathology confirmed metastatic uterine leiomyosarcoma.
Key takeaways
While a perilymphatic nodule distribution is the classic hallmark of sarcoidosis, coal worker's pneumoconiosis, or silicosis, hematogenous metastases (especially from leiomyosarcoma, thyroid, or breast carcinoma) can occasionally distribute in a lymphangitic or perilymphatic fashion, requiring histopathological confirmation.
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