An unusual cause of tree-in-bud pattern: pulmonary intravascular tumor embolism caused by chondrosarcoma

Lilia Silva Peixoto; Paulo Marcos Valiante; Rosana Souza Rodrigues; Miriam Menna Barreto; Gláucia Zanetti; Edson Marchiori

doi:10.1007/s00408-014-9659-5

An unusual cause of tree-in-bud pattern: pulmonary intravascular tumor embolism caused by chondrosarcoma

Lung. 2015 Feb;193(1):151-3. doi: 10.1007/s00408-014-9659-5. Epub 2014 Oct 16.

Authors

Lilia Silva Peixoto¹, Paulo Marcos Valiante, Rosana Souza Rodrigues, Miriam Menna Barreto, Gláucia Zanetti, Edson Marchiori

Affiliation

¹ Federal University of Rio de Janeiro, Rua Thomaz Cameron, 438. Valparaiso. CEP 25685.120. Petrópolis, Rio De Janeiro, Brazil.

PMID: 25318866
DOI: 10.1007/s00408-014-9659-5

Abstract

We report the case of a 45-year-old man who initially presented with chondrosarcoma of the left femur that was treated surgically. Follow-up chest computed tomography (CT) performed 3 years later showed multiple small nodules with a tree-in-bud branching pattern and larger elongated opacities with beaded contours. These findings raised the suspicion of intravascular tumor embolism. Pulmonary CT angiography demonstrated intravascular thrombosis and dilated and beaded peripheral pulmonary arteries. The tumoral origin of the thrombus was confirmed by lung biopsy.

Publication types

Case Reports

MeSH terms

Biopsy
Chondrosarcoma / diagnostic imaging
Chondrosarcoma / drug therapy
Chondrosarcoma / secondary*
Chondrosarcoma / surgery
Femoral Neoplasms / pathology*
Femoral Neoplasms / surgery
Humans
Lung Neoplasms / diagnostic imaging
Lung Neoplasms / drug therapy
Lung Neoplasms / secondary*
Male
Middle Aged
Multiple Pulmonary Nodules / diagnostic imaging
Multiple Pulmonary Nodules / drug therapy
Multiple Pulmonary Nodules / secondary*
Neoplastic Cells, Circulating / pathology*
Pulmonary Artery / diagnostic imaging
Pulmonary Artery / pathology*
Tomography, X-Ray Computed