title: The frequency and significance of radiologically detected indeterminate pulmonary nodules in patients with colorectal cancer.
abstract: OBJECTIVE
  To investigate the frequency and significance of pulmonary nodules in patients with colorectal cancer (CRC).
  
  
  METHODS
  Medical records of 1,344 patients with CRC who underwent thoracic computerized tomography scans between January 2003 and December 2009 were reviewed. Those with any distant metastatic disease or who were already known to have pulmonary malignancies were excluded. Number, size, shape and location of the nodules were evaluated. A multivariate analysis was performed to determine the predictive factors for evidence of metastases.
  
  
  RESULTS
  Of the 1,344 patients, 55 (4.09%) had nodules that met the criteria of an indeterminate pulmonary nodule. The mean follow-up time was 25 ± 17.9 months and the mean time to develop pulmonary metastasis was 15.5 ± 6.4 months. The nodules of 17 (30.9%) patients showed progression at follow-up; 8 had metastasized. Multivariate analysis showed multiple indeterminate pulmonary nodules (p = 0.006) of parenchymal localization (p = 0.016) with an irregular border (p = 0.002), which is predictive of metastatic disease.
  
  
  CONCLUSIONS
  Our study has shown that multiple indeterminate pulmonary nodules with an irregular border in a parenchymal location were more likely to represent metastatic disease. However, the frequency of the occurrence of indeterminate pulmonary metastases of CRC was low.
authors.affiliation: Department of Chest Diseases, Izmir M Enver Senerdem Torbalı Government Hospital, Izmir, Turkey.
authors.forename: Yelda
authors.initials: Y
authors.lastname: Varol
authors.forename: Umut
authors.initials: U
authors.lastname: Varol
authors.forename: Burcak
authors.initials: B
authors.lastname: Karaca
authors.forename: Bulent
authors.initials: B
authors.lastname: Karabulut
authors.forename: Canfeza
authors.initials: C
authors.lastname: Sezgin
authors.forename: Ruchan
authors.initials: R
authors.lastname: Uslu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000378:metabolism*; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed