J Korean Radiol Soc.  2002 Nov;47(5):507-511. 10.3348/jkrs.2002.47.5.507.

CT Findings of Small Bowel Metastases From Primary Lung Cancer

Affiliations
  • 1Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Korea. hkha@amc.seoul.kr

Abstract

PURPOSE
To evaluate the CT findings of small bowel metastases from primary lung cancer.
MATERIALS AND METHODS
Of the 1468 patients with primary lung cancer between 1990 and 2000, 13 patients who had metastasis to the small intestine were collected. Of these 13 patients, nine who underwent CT scan were included for analysis. The pathologic diagnoses of primary lung cancer in these nine patients were squamous cell carcinoma in six, adenocarcinoma in two, and large cell carcinoma in one. CT scans were analyzed with regard to the site and patterns (intraluminal mass/bowel wall thickening/bowel implants) of metastatic masses, and the presence or absence of complication such as intussusception, obstruction, or perforation of the small bowel. The medical records of the patients were also reviewed retrospectively for evaluation of presenting abdominal symptom and time interval of metastases from initial diagnosis of lung cancer.
RESULTS
Metastatic lesions were distributed throughout the small intestine: the duodenum in five, the jejunum in four, the ileum in six, and both jejunum and ileum in one patient. The size of metastatic masses of small bowel ranged from 1.3 cm to 5.0 cm (mean size, 2.6 cm) On CT, the small bowel was involved with intraluminal masses (mean size, 3.4 cm) in eight patients, diffuse wall thickening (mean thickness, 1.6 cm) in five, and bowel implants (mean size, 2.2 cm) in two. Complications occurred in seven patients, including intussusceptions without obstruction in two patients and with obstruction in two, obstruction without intussusceptions in two, and bowel perforation in one. Of 9 patients, 6 had at least one symptom referable to the small bowel including abdominal pain in 4, anemia in 3, vomiting in 1, and jaundice in 1. Lung cancer and small bowel lesions were detected simultaneously in four patients and the time interval of metastases from initial diagnosis of lung cancer ranged from 10 days to 30 months (median interval, 54 days) in 5 patients.
CONCLUSION
CT helps in defining the extent and pattern of small bowel metastases as well as in demonstrating their complication.

Keyword

Abdomen, CT; Abdomen, neoplasms; Lung neoplasms

MeSH Terms

Abdominal Pain
Adenocarcinoma
Anemia
Carcinoma, Large Cell
Carcinoma, Squamous Cell
Diagnosis
Duodenum
Humans
Ileum
Intestine, Small
Intussusception
Jaundice
Jejunum
Lung Neoplasms*
Lung*
Medical Records
Neoplasm Metastasis*
Retrospective Studies
Tomography, X-Ray Computed
Vomiting
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