Metastatic Pattern of Spread of Non-Small Cell Lung Carcinoma
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:
| Site | Frequency | Characteristics | Comments |
| Brain | Common | ||
| Bone | Common | Lytic | |
| 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 | Uncommon | Consolidation, 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 | 
|