Lung tumor - Metastastic tumors to lung

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Lung tumor

Other Carcinoma

Metastastic tumors to lung

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 12 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Lung is a common site of metastases - usually multiple, bilateral, sharply outlined, rapidly growing, more pleomorphic and necrotic than lung primaries, negative for TTF1
● May appear as multiple discrete nodules in periphery of lung, or as lymphangitis carcinomatosa (peribronchial and perivascular patterns via lymphatics)
● Rarely appear as intralymphatic microscopic foci that cause pulmonary hypertension
● Note: metastases can also be from other lung primaries (Am J Surg Pathol 2009;33:1752)

Patterns associated with specific primaries
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● Central cavitation: colonic adenocarcinoma, leiomyosarcoma, squamous cell carcinoma of upper aerodigestive tract
● Intrabronchial masses: breast, colon, kidney
● Lepidic pattern: colon, pancreas
● Lymphangitis carcinomatosis: breast, choriocarcinoma, pancreas, prostate, stomach
● Nodular metastases: breast, GI, kidney, melanoma., sarcoma
● Tumor emboli: breast, choriocarcinoma, liver, stomach

Case reports
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● 48 year old man with lymphangitic spread of hepatocellular carcinoma (Arch Pathol Lab Med 2003;127:e11)

Treatment
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● Excision of isolated nodules

Gross images
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Osteosarcoma

Multiple tumor nodules

Micro images
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Bladder, urothelial carcinoma

Breast, invasive ductal carcinoma

Chondrosarcoma, dedifferentiated

Colon: adenocarcinoma

Kidney: renal cell carcinoma

Liver: hepatocellular carcinoma

Oropharyngeal carcinoma

Prostate: adenocarcinoma

Testis: choriocarcinoma

Virtual slides
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Metastatic adenocarcinoma

Metastatic small cell carcinoma

Positive stains
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● CDX2 (colorectal carcinoma, Am J Surg Pathol 2003;27:141)

End of Lung tumor > Other carcinoma > Metastastic tumors to lung

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