CTICasesPulmonary Tumor Embolism from Hepatocellular Carcinoma
Imaging findings
Chest CT and abdominal MRI demonstrate a large hepatocellular carcinoma in the liver with direct extension and tumor thrombus involving the inferior vena cava. In the lungs, there are multiple large and small intravascular filling defects that expand the pulmonary arteries, representing extensive metastatic tumor emboli. Associated metastatic mediastinal lymphadenopathy is also present.
Key takeaways
Pulmonary tumor embolism is a rare but severe manifestation of metastatic disease, particularly associated with renal cell carcinoma, hepatocellular carcinoma, and breast cancer. Tumor emboli are characterized on CT by expansion of the pulmonary vessels and a nodular or beaded appearance, which distinguishes them from bland thromboemboli. Prognosis is generally poor.
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