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An odd case of multiple "cannonball metastases"
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The chest radiograph (see p 542) shows evidence of a raised left hemidiaphragm and a small left pleural effusion. Two pulmonary nodules, which have no visible calcification or cavitation but well defined margins, are noted overlying the left midzone. One lesion lies adjacent to and above the aortic knuckle, the other one adjacent to the left heart border.
A subsequent contrast enhanced spiral computed tomogram of her chest showed two small focal nodules in the right lobe, two moderate sized in the left upper lobe, and one large mass measuring approximately 6 x 9 x 11 cm replacing most of the left lower lobe, also a small left pleural effusion; there was no lymphadenopathy.
The differential diagnosis of multiple lung masses is quite complex, with metastatic disease being the most common cause. Other possibilities include an inflammatory process such as fungus, tuberculosis, nocardiosis, or septic emboli. In asymptomatic patients
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- An odd case of multiple "cannonball metastases"
- S Buchholz, P Szawarski, and S L Dawson
Postgrad. Med. J. 2003 79: 542-543.[Extract] [Full Text] [PDF]
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