A Cross sectional study of Chest metastasis patterns of all malignancies presented to radiology department at Tikur Anbesa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia from October 2018 – May 2019.
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Date
2019-10
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Addis Abeba University
Abstract
Back ground: Chest is one of the commonest metastasis site of the thoracic or extra thoracic
malignancies and Pulmonary metastases have widely variable presentation on imaging and may
simulate primary lung tumor or nonmalignant diseases. Therefore, it is important for the
radiologist to be familiar with the full spectrum of findings to facilitate correct diagnosis and this
study has tried to look for the pattern of chest metastasis.
Objective: This study aimed to assess the overall chest metastasis patterns of both thoracic and
extra thoracic malignancies and their possible histologic correlation.
Methods: A prospective cross sectional study of 202 patients was done from October 2018-
May 2019. A structured questionnaire was used to collect data for analysis.
Results: of the total 202 cases there are 25 primary sites and the majorities come from the
following sites in the descending order esophagus (63), breast (47), lung (24), bones (14), soft
tissues (10), thyroid (9), head and neck (11) and miscellaneous (24).
The commonly seen histologic variant is Squamous cell carcinoma (46 cases); majority from the
esophagus followed by Adenocarcinoma (26 case); majority from the breast and the lung
followed by sarcomas (24 cases) mainly from the bones and soft tissues and other miscellaneous
histologic variants account 16cases from different sources. For the rest of cases the histology is
not known.
The commonest metastatic site is found to be the lung parenchyma and air ways (accounting 120
cases with multinodular pattern being the commonest (67cases). The second is found to be the
mediastinum accounting 108 cases mainly involving the lymph nodes (106 cases). The 3
the pleura (58 cases) with the pleural nodule being the predominant pattern (24 cases). The last is
chest wall metastasis accounting for 53 cases mainly involving the bones (26 cases).
There is statistically significant positive correlation seen between the calcific metastasis and
sarcomas but no statistically significant correlation between other histologic types and lung
metastasis pattern.
Conclusion: In both thoracic and extra thoracic malignancies lung parenchymal and air way
metastasis is the commonest with multinodular pattern followed by lymphatic spread. The others
2
rd
site is
are mediastinal, pleural and chest wall metastasis respectively. Calcific metastasis has significant
positive correlation with sarcomas.
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Keywords
Chest ,metastasis ,thoracic malignancies