The screening of patients with a known primary extrathoracic malignancy for pulmonary metastasis may result in the identification of solitary or multiple pulmonary nodules. Radiologic features of these pulmonary nodules may suggest a diagnosis, but these features cannot reliably distinguish between benign and malignant etiologies. We present the case of a patient, diagnosed with carcinosarcoma of the bladder, who was found to have multiple pulmonary nodules by CT evaluation. Physical examination of the patient demonstrated the presence of cervical and axillary lymphadenopathy. An excisional biopsy of an axillary lymph node confirmed the diagnosis of Hodgkin's lymphoma. This case report demonstrates that radiographic information obtained by CT scan must be carefully correlated with the history and physical examination of the patient. This case report also demonstrates the importance of diagnostic biopsy of pulmonary nodularity discovered in patients with a known primary extrathoracic malignancy. The assumption that these pulmonary nodules represented metastatic malignancies would have had crucial prognostic and therapeutic implications.
Written by:
Perre A, Markman M. Are you the author?
Cancer Treatment Centers of America, Eastern Regional Medical Center, Philadelphia, Pa., USA.
Reference: Case Rep Oncol. 2011 Sep;4(3):592-6.
doi: 10.1159/000335346
PubMed Abstract
PMID: 22220156
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