An Unusual Presentation of Malignant Melanoma Metastatic to the Lungs and Bronchi. Bilateral Ground-Glass Opacities with a “Crazy Paving” Component

Kalchiem‐Dekel, Or; Maimon, Nimrod; Shack, Avram R.; Smoliakov, Alexander; Shaco‐Levy, Ruthy; Fruchter, Oren; Fox, Benjamin D.; Kramer, Mordechai R.; Galante, Ori

doi:10.1164/rccm.201411-1954im

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…Other unusual CT patterns of pulmonary involvement from malignant melanoma include diffuse ground-glass opacities, "crazy-paving" patterns, the "halo sign", endobronchial lesions, and cavitary nodules [4,[14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Two synchronous lung metastases from malignant melanoma: the same patient but different morphological patterns

Borghesi

Tironi

Michelini

et al. 2019

European Journal of Radiology Open

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Malignant melanoma is an aggressive cancer with a high metastatic potential. Among the multiple sites of metastatic disease, the lung is one of the most frequently involved sites. Typically, pulmonary metastases from malignant melanoma occur as solid nodules. Rarely, pulmonary involvement in metastatic melanoma occurs as subsolid nodules. The present article describes an unusual case of a patient with malignant melanoma that developed two synchronous pulmonary metastases with two different densities on CT images (one solid and the other subsolid) and different morphological patterns on histologic images. The radiologic-pathologic correlation of these two patterns of presentation was also reported.

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Section: Discussionmentioning

confidence: 99%

Two synchronous lung metastases from malignant melanoma: the same patient but different morphological patterns

Borghesi

Tironi

Michelini

et al. 2019

European Journal of Radiology Open

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“…Shin et al reported a diffuse infiltrative pattern consisting of intralobular interstitial thickenings and areas of ground-glass opacity in a pulmonary melanoma case, which was much like “paving” [6]. Kalchiem-Dekel et al also presented a diffuse interstitial metastatic “paving” pattern in the lung in a 51-year-old male patient [7]. Although “paving” surrounding a mass has been found in pulmonary adenocarcinoma [8] and PAP [9], it has not been previously associated with melanoma, making our case the first description of invasive pulmonary melanoma manifested as bilateral discrete nodules with a surrounding “paving” pattern.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

et al. 2016

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BackgroundIn the lung, melanoma is mostly arranged as patterns of multiple nodules, solitary nodules, or miliary invasions. Very rarely, it also displays a “crazy paving” pattern (also described as a “paving stone,” “flagstone,” or “slabstone” pattern), which is rarer still in discrete bilateral nodules. This pattern is considered to be caused by pulmonary alveolar proteinosis, but its association with various diseases is unclear.Case presentationA 60-year-old man was diagnosed with pulmonary melanoma. Computed tomography revealed discrete bilateral nodules surrounded by a “paving” pattern. A literature review found more than 40 types of diseases that have presented with “paving” patterns in the lung—predominantly pulmonary alveolar proteinosis, viral pneumonia, exogenous lipoid pneumonia, bacterial pneumonia, pulmonary alveolar microlithiasis, interstitial pneumonia, ARDS, squalene aspiration pneumonia, radiation pneumonitis, drug-induced pneumonitis, pulmonary leptospirosis, pulmonary hemorrhage, and pulmonary nocardiosis.ConclusionsWe describe the first case of pulmonary melanoma in the form of discrete bilateral nodules accompanied with a computed tomography paving pattern. Although pulmonary paving patterns are rare, more than 40 diseases reportedly display them; clinicians should consider melanoma of the lung in differential diagnoses for patients who show such a pattern.

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“…Of these 16 patients, 7 had a diagnosis of bronchioalveolar cell carcinomas making it the most common form of lung malignancy presenting as a ‘crazy-paving’ pattern. [ 2 3 5 - 9 ] Five had T-Cell lymphoma,[ 10 11 ] two melanomas,[ 4 8 ] and one patient each with AIDS-related Kaposi sarcoma[ 12 ] and lymphangitis carcinomatosis. [ 3 ] Information regarding unilateral/bilateral presentation was available in 12 patients.…”

Section: Discussionmentioning

confidence: 99%

“…[ 3 ] Information regarding unilateral/bilateral presentation was available in 12 patients. Nine of these 12 patients had a bilateral presentation,[ 2 - 4 8 - 13 ] while three had a unilateral appearance. [ 5 7 10 ] Of the seven patients with bronchioloalveolar carcinoma, four had bilateral,[ 2 3 9 13 ] while two had a unilateral presentation,[ 6 7 ] and in one patient, information was not available.…”

Section: Discussionmentioning

confidence: 99%

Unilateral ‘Crazy-Paving’ pattern: An exceptional presentation of squamous cell carcinoma of the lung

Shah

Banday

Khan

et al. 2022

Journal of Family Medicine and Primary Care

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A BSTRACT The ‘crazy-paving’ pattern on high resolution computed tomography (HRCT) is a distinct imaging appearance that is still considered to be a radiological hallmark of pulmonary alveolar proteinosis. However, since its first description about three decades ago, more than 40 different clinical entities presenting as ‘crazy-paving’ patterns have been documented. This rather remarkable but uncommon imaging appearance is now considered to be a non-specific manifestation. A 62-year-old male referred for evaluation of productive cough, breathlessness and fever presented with ‘crazy-paving’ pattern on HRCT. Endobronchial biopsy done on presentation was consistent with the diagnosis of squamous cell carcinoma. This report highlights this atypical presentation of squamous cell carcinoma of the lung and adds to the increasing list of clinical entities presenting as a ‘crazy-paving’ pattern. To our knowledge, squamous cell carcinoma presenting as a ‘crazy-paving’ pattern on HRCT is yet to be documented.

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An Unusual Presentation of Malignant Melanoma Metastatic to the Lungs and Bronchi. Bilateral Ground-Glass Opacities with a “Crazy Paving” Component

Cited by 6 publications

References 4 publications

Two synchronous lung metastases from malignant melanoma: the same patient but different morphological patterns

Two synchronous lung metastases from malignant melanoma: the same patient but different morphological patterns

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

Unilateral ‘Crazy-Paving’ pattern: An exceptional presentation of squamous cell carcinoma of the lung

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