Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Endobronchial and lung metastases from renal cell carcinoma
- Radiologic Findings
- Figs 1-2. Pre-contrast chest CT images show atelectasis with bronchial obstruction in the lateral segment of right middle lobe. A subpleural small nodule is also noted in the left lower lobe.
Fig 3-5. Contrast-enhanced CT images show well enhancement of endobronchial in the right middle lobe and lung nodules in the both lower lobes.
Fig 6. FDG PET/CT scan shows no avid FDG uptake in the whole body.
- Brief Review
- The common sources of endobronchial metastases are kidney, breast, and colorectal cancers. Renal cell carcinomas are hypervascular tumors and endobronchial metastases from renal cell carcinoma (RCC) show very high attenuation (84-128 H.U) and strong enhancement (51.6-93.3) on the contrast-enhanced CT images
Unlike for most other malignancies, application of FDG PET/CT is limited for RCC, mainly due to physiological excretion of FDG from the kidneys, which decreases contrast between renal lesions and normal tissue. RCC have inconsistent FDG uptake, which may be due to hypo- or isometabolism relative to background tissues and heterogeneity of glucose transporter expression (GLUT-1 gene). Generally, GLUT-1 gene is overexpressed at high grade clear cell RCC and it leads to high FDG uptake.
- References
- 1. Liu Y., The Place of FDG PET/CT in Renal Cell Carcinoma: Value and Limitations. Front Oncol. 2016; 6;6:201.
2. Dursan, A.B.,et al., Endobronchial metastases: a clinicopathological analysis. Respirology 2005;10(4):510-514.
3. Park CM et al., Endobronchial metastases from renal cell carcinoma: CT findings in four patients. Eur J Radiol 2004;51(2):155-9.
- Keywords
- airway, lung, airway, malignant neoplasm , metastasis,