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Metastatic Pattern of Spread of Non-Small Cell Lung Carcinoma  adult

Introduction: Combining adenocarcinoma and squamous cell carcinoma of the lung. Within adenocarcinoma is an entity previously known as bronchoalveolar cell carcinoma (BAC, currently minimally invasive adenocarcinoma), which is rare.

40% of patients have metastatic disease at presentation.

Prevalence: Common Metastasis Frequency: Common

References:
Ann Thorac Surg. 1996 Jul;62(1):246-50. PMID: 8678651


Primary Tumor:

 Characteristics Comments
Lung Parenchyma Consolidation, Spiculated, Cavitary BAC presents as a single or multiple consolidations (in early stages, it appears as a ground-glass opacity). SCC is more likely to cavitate.

Known Metastatic Locations:

SiteFrequencyCharacteristics Comments
Brain Common
Bone CommonLytic
Liver Common
Adrenal Glands Common Note that about 2/3 of isolated adrenal masses seen at diagnosis of lung cancer are benign (Radiology. 1984 Oct;153(1):217-8. PMID: 6473783).

Adeno much more likely to metastasize to adrenals than SCC.

Chest Wall Uncommon
Lung Parenchyma UncommonConsolidation, Nodule, Lymphangiitic bronchoalveolar metastases appear as consolidation, while classical lung cancers will just appear as nodules (or lymphangiitic spread)
Spleen Rare
Distant Lymph Nodes Rare abdominal or axillary lymph nodes are rare sites for metastasis in general. However, axillary nodes are more common with SCC.
Spinal Cord Very Rare
Pancreas Very Rare
Kidney Very Rare
radiology image: