Pulmonary metastases from angiosarcoma: a spectrum of CT findings

Abstract

Cysts showed variability in their walls, and air-fluid levels and vessels or bronchi penetrating the cysts appeared to be characteristic findings, which may be useful for detection and accurate diagnosis in patients with pulmonary metastases from angiosarcoma.

Angiosarcoma in the chest

“…From these 4 findings, other possible complications can arise, including pneumothorax, hydropneumothorax, and pneumomediastinum. Our observations show a concordance with larger series already published [14] : significant representation of nodules with halo sign; the halo sign representing surrounding alveolar hemorrhage from these highly vascular neoplasms involving pre-existing vessels in the lung.…”

“…These aspects are quite unusual and suggestive of a variety of neoplastic cystic lesions such as metastatic sarcomas, mesenchymal cystic hamartoma, and infections (cystic evolution of Pneumocystis jirovecii pneumonia). This case had similarities with the cases described by Yogi et al [14] …”

“…This appears to be the most common pattern in the literature; some cases may mimic pulmonary emboli. [6,10,14,19] Consolidation. When solid metastatic lesions enlarge, like in Patient 3, they can become consolidative usually without air bronchograms.…”

“…The immediate consequence of this evolution is represented by complications such as pneumothorax and pneumomediastinum, particularly when cysts are beneath the pleura. Even though only few reports describe cysts as secondary lesions, [12,14,16,17] they may explain pneumothorax as a manifestation of metastatic angiosarcoma. [1] …”

“…A distinctive feature in some metastatic angiosarcomas is a halo of ground glass change around nodules representing perinodular hemorrhage into alveoli, the so-called “halo sign.” [13,14] …”