title: An unusual cause of tree-in-bud pattern: pulmonary intravascular tumor embolism caused by chondrosarcoma.
abstract: We report the case of a 45-year-old man who initially presented with chondrosarcoma of the left femur that was treated surgically. Follow-up chest computed tomography (CT) performed 3 years later showed multiple small nodules with a tree-in-bud branching pattern and larger elongated opacities with beaded contours. These findings raised the suspicion of intravascular tumor embolism. Pulmonary CT angiography demonstrated intravascular thrombosis and dilated and beaded peripheral pulmonary arteries. The tumoral origin of the thrombus was confirmed by lung biopsy.
authors.affiliation: Federal University of Rio de Janeiro, Rua Thomaz Cameron, 438. Valparaiso. CEP 25685.120. Petrópolis, Rio De Janeiro, Brazil.
authors.forename: Lilia Silva
authors.initials: LS
authors.lastname: Peixoto
authors.forename: Paulo Marcos
authors.initials: PM
authors.lastname: Valiante
authors.forename: Rosana Souza
authors.initials: RS
authors.lastname: Rodrigues
authors.forename: Miriam Menna
authors.initials: MM
authors.lastname: Barreto
authors.forename: Gláucia
authors.initials: G
authors.lastname: Zanetti
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
mesh_terms: D001706:Biopsy; D002813:Chondrosarcoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D005266:Femoral Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed