Lymphangitic Spread of Metastatic Cancer to the Lung

Autopsy diagnosis of pulmonary lymphangitic carcinomatosis was made in 23 cases in which recent chest radiographs were available. Three radiologic groups were evident: Group I—5 cases with both parenchymal nodules and an interstitial linear pattern; Group II—10 cases with an interstitial linear pattern only; Group III—8 cases in which the lungs appeared normal. The radiologic-pathologic correlation was excellent. Lymph nodes contained metastatic tumor in 11 cases while arterial tumor emboli were identified in 20 of the 23 cases. The pathogenic mechanism of such tumor spread may be primarily vascular embolization rather than retrograde spread from central lymphnode involvement.