Pulmonary manifestations of extrathoracic malignant lesions.

Two of the most common thoracic manifestations of extrapulmonary malignant tumors are thoracic metastatic lesions and pulmonary thromboembolism. Recognition of the broad array of patterns of pulmonary metastatic involvement is essential for optimal management of oncology patients. In addition to the "typical" pattern of multiple bilateral nodules, patients may have solitary nodules, reticulonodular infiltrates, hilar and mediastinal adenopathy, endobronchial obstruction, pleural disease, or even normal roentgenographic findings. An awareness of the association between cancer and pulmonary thromboembolism is also valuable. The mechanisms potentially responsible for the thrombotic events associated with malignant disease are discussed, and diagnostic issues are reviewed.