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Tree-in-bud sign as a manifestation of localized pulmonary lymphatic metastasis from a pancreas cancer.

Authors
Type
Published Article
Journal
Internal medicine (Tokyo, Japan)
Publication Date
Volume
50
Issue
24
Pages
3027–3029
Identifiers
PMID: 22185998
Source
Medline
License
Unknown

Abstract

The tree-in-bud appearance usually reflects benign disorders of the bronchovascular bundle. Pulmonary metastasis reportedly also shows a tree-in-bud pattern in cases of dilated peripheral pulmonary artery filled with intravascular tumor emboli or fibrocellular intimal hyperplasia of the small pulmonary arteries induced by tumor microemboli, or endobronchial metastatic disease. On X-ray CT, pulmonary metastases may result in four main types of imaging manifestations: nodules, lymphatic spread, tumor emboli, and endobronchial tumor, and show diffuse interstitial thickening or multiple nodules in general. We report a rare case of localized pulmonary peribronchovascular lymphatic tumor spread without intravascular tumor emboli from a pancreas cancer, which mimicked the localized vascular tree-in-bud sign.

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