title: The microenvironment in the human lung partly determines the site of the first metastasis.
abstract: BACKGROUND
  Due to local ventilation and perfusion differences in the pulmonary lobes, the microenvironmental influence on metastasis formation in the lung can be studied. We, therefore, investigated whether the anatomical distribution of first lung metastases follow a particular pattern.
  
  
  METHODS
  Thirty-three out of 273 patients with melanoma who underwent 18F-fluorodeoxyglucose positron emission tomography and computed tomography (18FDG-PET/CT) were identified as patients with detected primary pulmonary metastases. All solitary metastases were allocated to the appropriate lung segment.
  
  
  RESULTS
  Segment L3 had the significantly highest number of metastases (n=11; p<0.001). Overall, both upper lung lobes manifested numerously more metastases in comparison to the lower lobes (26 metastases (70%) vs. 11 metastases (30%); p<0.001).
  
  
  CONCLUSIONS
  Our results provide novel information supporting the hypothesis that pulmonary metastases occur prevalently in the upper lung segments.
authors: Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany m.yanar@uke.de.
authors: Merve
authors: M
authors: Yanar
authors: Department of Life Sciences, Hamburg University of Applied Sciences, Hamburg, Germany.
authors: Florian
authors: F
authors: Abel
authors: Department of Dermatology-Health Care Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Thomas
authors: T
authors: Haalck
authors: Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Susanne
authors: S
authors: Klutmann
authors: Department of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Udo
authors: U
authors: Schumacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008168:Lung / Q000166:cytology* / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D059016:Tumor Microenvironment
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG; Malignant melanoma; cell adhesion; lung; neoplasm metastasis