CT evaluation for pulmonary metastases in patients with extrathoracic malignancy

Article Abstract:

In many cancer patients, cancer originating in another organ spreads (metastasizes) to the lungs. These pulmonary metastases are often not diagnosed until after the patient has died. Thus, an early diagnosis of lung involvement could result in better treatment. As cancer spreads, it generally follows certain pathways. Organs such as the lungs and the liver act as filters. Cancerous cells that break away form the original site can be carried by the blood to these organs. When the lungs are involved in secondary cancer disease, it is usually characterized by the formation of many nodules in the peripheral part of the lung. These nodules vary in size and are initially very small. They cannot be detected with diagnostic imaging techniques until they reach a certain size. Many studies have examined whether computed tomography (CT) is better at detecting these nodules than conventional X-rays. CT, a diagnostic imaging technique in which data from scanning X-rays are generated into images by a computer, can give much more detailed images than does a plain X-ray, and thus may be more sensitive in detecting pulmonary metastases. This report reviews the use of CT in detecting lung involvement in cancer patients. Results to date have been somewhat conflicting, but it is generally accepted that CT is more sensitive, in that it is better able to detect nodules, but it is less specific, in that it more frequently detects nodules that are not cancerous. The specificity can be improved by considering other clinical factors, such as the patient's underlying disease. Final diagnosis, however, should be made from tissue samples. Once the cancer is diagnosed, surgery may be required, and CT may be useful in presurgical examination. It is even more useful when chemotherapy or radiation therapy is opted for. CT appears to be an effective tool for the early diagnosis of the spread of cancer to the lungs. Further studies are required to see whether the improved diagnostic ability results in increased survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Usage, CT imaging, CAT scans, Cancer, Cancer treatment, Metastasis, Cancer metastasis, Lung tumors, editorial

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Cortical bone metastases

Article Abstract:

Cancer involving bones usually results from the metastasis (spread) of a primary tumor that originated in another organ of the body. Metastatic cancer in bone usually affects the marrow. Some recent reports have indicated that cancer originating in the lungs and airways can spread to the cortex of the bone and that this type of metastasis is unique to that type of cancer. Since metastasis to the bone cortex requires arterial dissemination from the primary tumor, there should not be a reason that other cancers could not also spread to bone cortex. The bone scans and X-rays from 1,237 patients evaluated for possible skeletal metastases were reexamined for the presence of cortical involvement. Results showed that 36 cortical metastases were present in 32 long bones in 27 patients. The primary tumors involved were of various types, including those that originated in the breast, kidney, larynx, lung, pancreas, and uterus. The results indicated that cortical bone metastases are both more common than originally thought and can originate from sources other than bronchogenic cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Cancer invasiveness, Bone cancer

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