Endobronchial Metastasis: CT Findings and Its Usefulness in Bronchoscopic Correlation

Ko, Ji Ho; Jung, Gyoo Sik; Kim, Seong Min; Huh, Jin Do; Joh, Young Duk; Jang, Tae Weon

Abstract

PURPOSE: To evaluate the CT findings of bronchial abnormalities in patients with endobronchial metastasis from extrapulmonary tumors, and to correlate these with the bronchoscopic findings.
MATERIALS AND METHODS
The authors retrospectively reviewed the CT and bronchoscopic findings of 17 patients (M:F=9:8; mean age, 56 years) with histologically proven endobronchial metastasis from extrapulmonary primary tumors. Carcinoma of the uterine cervix (n = 5) was the most common primary site for endo-bronchial metastasis. CT findings of bronchial abnormalities with associated peribronchial and lung parenchymal lesions were analyzed and compared with the bronchoscopic findings.
RESULTS
Among the 17 patients, 20 sites of bronchial abnormalities were visualized bronchoscopically. CT findings of bronchial abnormalities were smooth narrowing (n = 11), occlusion (n = 3), intraluminal mass (n= 4), and normal (n = 2). Peribronchial lesions(lymph node enlargement or parenchymal mass) were found in 12 cases. Bronchoscopy revealed bronchial narrowing due to a mucosal nodule or intraluminal polypoid mass in 16 cases, and total obstruction of the bronchus in four. With regard to the identification of bronchial abnormalities, the findings of CT and of bronchoscopy agreed in 17 cases and disagreed in three. While bronchoscopy was advantageous for detecting early mucosal abnormality, CT effectively evaluated the extent of a lesion beyond the stenosis or bronchial obstruction. CT was also useful for predicting the causes of bronchial abnormalities.
CONCLUSION
CT is relatively accurate in evaluating bronchial abnormalities, and in patients with endo-bronchial metastases may be used as a complementary procedure to bronchoscopy for evaluating the extent of the lesion.