Metastatic Malignant Tumors to the Bronchus Found in Bronchial Biopsy and Secretions

¹ Department of Pathology, Birmingham Veterans Administration Hospital, Van Nuys, California.

1) Metastatic pulmonary tumors which erode bronchi and extend into lumens may be detected by bronchial biopsy and cytologic examination of secretions.

2) Two such cases are reported: first, an adenocarcinoma of the sigmoid colon which had metastasized to the lung as a solitary nodule, and had eroded through the bronchus of the lower lobe of the right lung; and second, a malignant melanoma which had metastasized as multiple nodules to both lungs. In both, malignant cells were detected in the bronchial biopsies and secretions. The second case is also of interest because it presented metastatic calcification.

3) A third case of intrabronchial polypoid tumor, metastatic from a rhabdomyosarcoma of the kidney, was encountered at necropsy.

4) To the bronchoscopist, a polypold intrabronchial lesion should suggest a metastatic tumor or bronchial adenoma, since bronchogenic carcinomas in the majority of instances tend to grow into the lung parenchyma rather than into the lumen. Bronchogenic carcinomas encircle the bronchial wall and cause rigidity and stenosis of the bronchus, rather than project into bronchial lumens as polypoid masses.

5) Care must be taken in evaluating positive bronchial biopsies or aspirates in order to avoid designating metastatic lesions as primary bronchogenic neoplasms.