Solitary pulmonary nodule with extra pulmonary neoplasms

ABSTRACT

Background: A solitary pulmonary nodule is defined as a discrete, well - marginated, rounded opacity less than or equal to 3 cm in diameter that is completely surrounded by lung parenchyma, does not touch the hilum or mediastinum , and is not associated with adenopathy, atelectasis or pleural effusion. Lesions larger than 3 cm are considered masses and are treated as malignancies until proven otherwise. It is not uncommon for a patient who currently has or has previously had extra pulmonary neoplasm to develop a solitary pulmonary nodule. Such a nodule may be detected with chest radiography or computed tomography performed as part of the work - up or follow - up of the known extra pulmonary malignancy. The determination of the etiology of such a nodule is usually important to direct the appropriate therapy. Aim and objectives: To evaluate the Chest Radiographs and CT characteristics of solitary lung nodule with a primary extra pulmonary neoplasm and to determine the presence and/or frequency of single lung metastasis , primary lung cancer and benign lesions in patients with solitary lung nodule and a primary extra pulmonary neoplasm. Materials and methods: A retrospective analysis of CT and Chest Radiographs of 9 patients with an extra pulmonary malignant neoplasm and a solitary pulmonary nodule, done in our Dhiraj General Hospital. Images were reviewed for the presence of solitary lung nodule. If present, the following nodular characteristics were recorded Distribution, CT attenuation, Shape, Size, Margins and Calcification. The histological characteristics of the nodule were correlated with those of the extra pulmonary neoplasm and with patient age and smoking history. Results: Out of total number of 9 patients that were included in this study showed different pathologies and those were then those were evaluated in detail and showed benign pulmonary nodule (1 case), metastatic deposit (1 case), primary bronchogenic carcinoma with brain metastasis (1 case), Hrituraj Singh, C. Raychaudhuri. Solitary pulmonary nodule with extra pulmonary neoplasms. IAIM, 2017; 4(5) 1-7. Page 2 lung metastasis (1 case), lung carcinoma in upper lobe of left lung (1 case), actinomycosis (1 case), lung metastasis with renal cell carcinoma (1 case), oesophageal carcinoma with primary bronchogenic carcinoma (1 case), primary bronchogenic carcinoma with bony metastasis (1 case). Conclusion: Solitary lung nodule in patients with extra pulmonary malignancies showed a variety of patterns on CT. Nearly half of the non – calcified solitary pulmonary nodules identified in this series were malignant. The likelihood of a spread depends on the histological characteristics of the extra pulmonary neoplasm and the patient's smoking history. Lung cancer was more common than metastatic disease.