EURORAD ESR

Case 15360

Tracheobronchial metastasis from rectal cancer.

Author(s)
Dr. N. Bossu

UZ Leuven, Gasthuisbergs; Herestraat 49 3000 Leuven, Belgium; Email:bossu.nicolas@gmail.com
 
Patient
male, 61 year(s)
 
 
  • Figure 1
    Contrast-enhanced CT of the lung
     

    Coronal reformatted contrast enhanced CT in lung window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density...

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Axial contrast enhanced CT in lung window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density 80 HU with foci...

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Axial contrast enhanced CT in lung window: Recurrence of a nodular lesion measuring 26 mm in diameter in the right hilum in the basal part of the RUL.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Sagittal reformatted contrast enhanced CT in lung window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density...

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Axial contrast enhanced CT in mediastinal window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density 80 HU...

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Axial contrast enhanced CT in mediastinal window: Recurrence of a nodular lesion measuring 26 mm in diameter in the right hilum in the basal part of the RUL.

     
    Area of Interest: Thorax; Imaging Technique: CT-High Resolution; Procedure: Diagnostic procedure; Special Focus: Metastases;
     
     
  • Figure 2
    FDG PET-CT 3 weeks prior
     

    Native CT images of the PET-CT (3 weeks prior), axial reformatted: Retrospective of a small lesion on the left lateral wall of the distal trachea can be seen.

     
    Area of Interest: Thorax; Imaging Technique: PET-CT; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Native CT images of the PET-CT (3 weeks prior), coronal reformatted: Retrospective a small lesion on the left lateral wall of the distal trachea can be seen.

     
    Area of Interest: Thorax; Imaging Technique: PET-CT; Procedure: Diagnostic procedure; Special Focus: Metastases;

    PET-CT fusion image (3 weeks prior) shows discrete metabolic activity of the smaller lesion on the left tracheal wall, but difficult to ascertain due to the size.

     
    Area of Interest: Thorax; Imaging Technique: PET-CT; Procedure: Diagnostic procedure; Special Focus: Metastases;

    PET-CT fusion image (3 weeks prior) shows high metabolic activity of the right hilar mass.

     
    Area of Interest: Thorax; Imaging Technique: PET-CT; Procedure: Diagnostic procedure; Special Focus: Metastases;

    PET-CT fusion image (3 weeks prior) shows high metabolic activity of the right hilar mass, probably discrete metabolic activity of the smaller lesion on the left tracheal wall but difficult to ascertain.

     
    Area of Interest: Thorax; Imaging Technique: PET-CT; Procedure: Diagnostic procedure; Special Focus: Metastases;
     
     
  • Figure 3
    Surface rendered virtual bronchoscopy view
     

    Surface volume rendering at level of carina shows endoluminal mass from the left tracheobronchial angle.

     
    Area of Interest: Thorax; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Surface volume rendering at level of carina shows endoluminal mass from the left tracheobronchial angle.

     
    Area of Interest: Thorax; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Pulmo 3D reconstruction showing endoluminal impression originating from the left tracheal wall corresponding to tracheal mass.

     
    Area of Interest: Thorax; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Metastases;

    Pulmo 3D reconstruction showing endoluminal impression from the left tracheal wall corresponding to tracheal mass.

     
    Area of Interest: Thorax; Imaging Technique: Image manipulation / Reconstruction; Procedure: Diagnostic procedure; Special Focus: Metastases;
     
     
  • Figure 4
    Flexible Fiberoptic Bronchoscopy at level of carina
     

    Trachea: Mucosal lesion at left tracheobronchial angle with additional bronchoscopic biopsy. Pathologic examination revealed adenocarcinoma, compatible with metastasis of known rectal adenocarcinoma.

     
    Area of Interest: Thorax; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Metastases;

    Trachea: Mucosal lesion at left tracheobronchial angle with additional bronchoscopic biopsy. Pathologic examination revealed adenocarcinoma, compatible with metastasis of known rectal adenocarcinoma.

     
    Area of Interest: Thorax; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Metastases;
     
     
Coronal reformatted contrast enhanced CT in lung window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density 80 HU with foci of 120 HU.
 
Axial contrast enhanced CT in lung window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density 80 HU with foci of 120 HU.
 
Axial contrast enhanced CT in lung window: Recurrence of a nodular lesion measuring 26 mm in diameter in the right hilum in the basal part of the RUL.
 
Sagittal reformatted contrast enhanced CT in lung window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density 80 HU with foci of 120 HU.
 
Axial contrast enhanced CT in mediastinal window: Small endoluminal irregularity adherent to the left tracheobronchial wall (diameters 10 mm anteroposterior x 5 mm laterolateral x 8 mm craniocaudal), density 80 HU with foci of 120 HU.
 
Axial contrast enhanced CT in mediastinal window: Recurrence of a nodular lesion measuring 26 mm in diameter in the right hilum in the basal part of the RUL.
 
Native CT images of the PET-CT (3 weeks prior), axial reformatted: Retrospective of a small lesion on the left lateral wall of the distal trachea can be seen.
 
Native CT images of the PET-CT (3 weeks prior), coronal reformatted: Retrospective a small lesion on the left lateral wall of the distal trachea can be seen.
 
PET-CT fusion image (3 weeks prior) shows discrete metabolic activity of the smaller lesion on the left tracheal wall, but difficult to ascertain due to the size.
 
PET-CT fusion image (3 weeks prior) shows high metabolic activity of the right hilar mass.
 
PET-CT fusion image (3 weeks prior) shows high metabolic activity of the right hilar mass, probably discrete metabolic activity of the smaller lesion on the left tracheal wall but difficult to ascertain.
 
Surface volume rendering at level of carina shows endoluminal mass from the left tracheobronchial angle.
 
Surface volume rendering at level of carina shows endoluminal mass from the left tracheobronchial angle.
 
Pulmo 3D reconstruction showing endoluminal impression originating from the left tracheal wall corresponding to tracheal mass.
 
Pulmo 3D reconstruction showing endoluminal impression from the left tracheal wall corresponding to tracheal mass.
 
Trachea: Mucosal lesion at left tracheobronchial angle with additional bronchoscopic biopsy. Pathologic examination revealed adenocarcinoma, compatible with metastasis of known rectal adenocarcinoma.
 
Trachea: Mucosal lesion at left tracheobronchial angle with additional bronchoscopic biopsy. Pathologic examination revealed adenocarcinoma, compatible with metastasis of known rectal adenocarcinoma.
 
 
 
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