Abstract
Chest X-ray findings of 147 cases of pulmonary metastases were studied andradiographically divided into three types. Furthermore, the extirpated lungs in 20 caseswere studied for evaluating the radio-pathologic correlations soft X-ray films ofthe specimen were compared with the macrosection.Radiographic classification of the pulmonary metastases; Type I: Nodular shadowsalone, Type II: Strand and linear markings without nodular shadows, Type III: Mixedtype of Type I and Type II-Nodular shadows associated with strand and linearmarkings.
The lesion circumscribed by the capsule showed an expansive growing and wasconsidered to occur by embolic extension. Radiographically, the lesions showedsharply defined, smooth nodular shadows.The lesion with lymphangitic spread by way of the peribronchial and perivascularlymphatics showed and linear markings on a chest X-ray film. Invasive growing ofthe lesions had more or less lymphagitic spread and, on a chest X-ray film, could beseen as ill defined nodular shadows with or without strand and linear markings.
In this investigation, about 47 % of the case with strand and linear markings wereassociated with hilar enlargement, but more frequently (in 91 %) associated withnodular shadows. The fact may suggest a possibility that the lymphangitic spread mustbe occur secondarily as result of the hematogenous metastases.
In comparison with primary lung cancer, solitary metastatic lesion frequentlyshowed sharply defined and smooth shadow and less frequently had the secondary changes such as atelectasis and obstructive pneumonia.
