title: Pulmonary metastases from angiosarcoma: a spectrum of CT findings.
abstract: BACKGROUND
  Though a few reports have summarized the computed tomography (CT) findings of pulmonary metastases from angiosarcoma, the detailed CT findings of cysts are not well known, except for their characteristic thin walls.
  
  
  OBJECTIVE
  To retrospectively summarize the CT findings of pulmonary metastases from angiosarcoma, focusing mainly on the CT findings of cysts.
  
  
  METHODS
  Thirty-three patients with pulmonary metastases from angiosarcoma were selected retrospectively. Two radiologists reviewed and assessed patients' chest CT images on a consensus basis for nodules, cysts, the CT halo sign, pneumothorax, pleural effusion, and enlarged lymph nodes. Cysts were also evaluated by wall thickness and smoothness, air-fluid levels, and vessels or bronchi penetrating the cysts. The relationship between cysts and pneumothorax was assessed using the Chi-square test.
  
  
  RESULTS
  Nodules were found in 28 (85%) patients. Cysts were found in 19 (58%) patients; 17 had thin and smooth walls, 10 had thin and irregular walls, and four had thick and irregular walls. In addition, 12 patients showed vessels or bronchi penetrating the cysts, and six showed air-fluid levels. The CT halo sign, pneumothorax, pleural effusion, and mediastinal lymphadenopathy were seen in 19 (58%), 16 (48%), 26 (78.8%), and five (15.2%) patients, respectively. Pneumothorax occurred significantly more frequently in patients with cysts (P = 0.002).
  
  
  CONCLUSIONS
  Cysts showed variability in their walls, and air-fluid levels and vessels or bronchi penetrating the cysts appeared to be characteristic findings, which may be useful for detection and accurate diagnosis in patients with pulmonary metastases from angiosarcoma.
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan jxo98ayg@med.u-ryukyu.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Yogi
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan Department of Radiology, Okinawa Prefectural Yaeyama Hospital, Okinawa, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Miyara
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Department of Radiology, Okinawa Prefectural South Medical Center / Pediatric Medical Center, Okinawa, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Iraha
authors.affiliation: Departments of Dermatology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Matori
authors.affiliation: Department of Infections, Respiratory and Digestive Medicine Control and Prevention of Infectious Diseases (The First Department of Internal Medicine), Faculty of Medicine, University of the Ryukyus.
authors.forename: Shusaku
authors.initials: S
authors.lastname: Haranaga
authors.affiliation: Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan.
authors.forename: Sadayuki
authors.initials: S
authors.lastname: Murayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media; D005260:Female; D006394:Hemangiosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Thorax; adults; computed tomography (CT); cysts; lung; metastases