title: Diffuse airway narrowing from carcinoma metastatic to the bronchial submucosa: identification by chest CT.
abstract: The differential diagnosis of dyspnea in patients with prior malignancy and nondiagnostic chest radiographs is broad. We report a case of breast carcinoma diffusely metastatic to the bronchial submucosa presenting as obstructive airway disease. Chest radiographs failed to suggest metastatic disease as the cause of dyspnea. CT, however, revealed the unusual finding of diffusely thickened and narrowed airways. Carcinoma confined to airway submucosa was identified using bronchial biopsy. We suggest that diffuse airway narrowing from submucosal metastasis can be demonstrated by CT and should be added to the differential diagnosis of dyspnea in cancer patients with nondiagnostic chest radiographs and evidence of airflow obstruction.
authors.affiliation: Division of Pulmonary and Critical Care, University of Pennsylvania Medical Center, Philadelphia 19104-4283, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Taichman
authors.forename: G
authors.initials: G
authors.lastname: Tino
authors.forename: J
authors.initials: J
authors.lastname: Aronchick
authors.forename: C
authors.initials: C
authors.lastname: Reynolds
authors.forename: W R
authors.initials: WR
authors.lastname: Smythe
authors.forename: J R
authors.initials: JR
authors.lastname: Roberts
authors.forename: D
authors.initials: D
authors.lastname: Haller
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D000368:Aged; D000402:Airway Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D001706:Biopsy; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D001984:Bronchial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed