J Korean Soc Radiol.  2018 Apr;78(4):284-288. 10.3348/jksr.2018.78.4.284.

Pulmonary Metastasis Originated from Uterine Sarcoma, Presenting as Multiple Nodules with Tortuous, Serpentine, Aneurysmal, Dilated Intratumoral Vessels: A Case Report

• Jang HJ
• Kim SS
• Park HS
• Lee JE
• Kim JH

• KMID: 2407934
• DOI: http://doi.org/10.3348/jksr.2018.78.4.284

Abstract

Pulmonary metastases present a wide spectrum of radiological findings, some of which have been known to be useful for analogizing the possible origin or site of primary tumors. In the present report, we describe a unique case of pulmonary metastasis manifesting on chest computed tomography as multiple nodules with tortuous, serpentine, aneurysmal, dilated, inner intratumoral vessels. The metastasis originated from uterine sarcoma.

MeSH Terms

Aneurysm*
Lung Neoplasms
Neoplasm Metastasis*
Sarcoma*
Thorax
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A 60-year-old woman with pulmonary metastasis from uterine sarcoma, presenting as multiple nodules with tortous, serpentine, aneurysmal dilated intraumor vessels. A. Initial chest radiograph shows multiple, round, variably sized nodules and masses in both lungs, as well as a small amount of pleural effusion. B. Pre-enhanced image shows well-defined homogeneous, variably sized, soft-tissue nodules with a density similar to that of the back muscles and no inner calcific foci. C. Axial contrast-enhanced CT image shows aneurysmal dilatated intratumoral vessel (thick arrow). It has no connection with adjacent branch of the pulmonary artery (thin arrow). D. Coronal contrast-enhanced CT image also show aneurysmal dilatated intratumoral vessels (thick arrows). Branches of the pulmonary artery (thin arrows) pass through the nodules without any connection. E. Coronal contrast-enhanced CT image show multiple variable sized nodues and masses with tortous, dilatated intratumoral or intranodal vessels with an inner cystic or necrotic portion. F. Photomicrographs show tumor cell infiltration with circumscribed cystic spaces lined with flat, endothelial-like cells (arrow), suggesting vascular structures (hematoxylin and eosin, × 100). Cystic spaces show CD-31 positivity (CD-31, × 100) and tumor cells react strongly with mesenchymal antigen (Vimentin, × 400). CD-31 = cluster of differentiation-31, CT = computed tomography

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