Diffuse Airway Narrowing From Carcinoma Metastatic to the Bronchial Submucosa

Identification by Chest CT

¹ From the Divisions of Pulmonary and Critical Care, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, PA.
² Department of Radiology, University of Pennsylvania Medical Center, Philadelphia, PA.
³ Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, PA.
⁴ Division of Thoracic Surgery, Department of Surgery, University of Pennsylvania Medical Center, Philadelphia, PA.
⁵ From the Division of Oncology, Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, PA.

Gregory Tino, MD, Pulmonary and Critical Care Division, University of Pennsylvania Medical Center, 3600 Spruce Street, 831 Gates Building, Philadelphia, PA 19104-4283; e-mail: gregtino{at}mail.med.upenn.edu

The differential diagnosis of dyspnea in patients with prior malignancy and nondiagnostic chest radiographs is broad. We report a case of breast carcinoma diffusely metastatic to the bronchial submucosa presenting as obstructive airway disease. Chest radiographs failed to suggest metastatic disease as the cause of dyspnea. CT, however, revealed the unusual finding of diffusely thickened and narrowed airways. Carcinoma confined to airway submucosa was identified using bronchial biopsy. We suggest that diffuse airway narrowing from submucosal metastasis can be demonstrated by CT and should be added to the differential diagnosis of dyspnea in cancer patients with nondiagnostic chest radiographs and evidence of airflow obstruction.

Key Words: breast neoplasms • bronchial neoplasms • metastasis • tomography • radiograph-computed

Submitted on May 26, 1998
Accepted on June 16, 1998