Metastatic tumours of lungs

Metastases in lungs can give any primary malignant tumours, present in other organs and tissues of organism. However often they are observed at cancer of suckling gland, stomach, adrenal glands, at an osteogenic sarcoma, chorionepitelioma. The characteristic feature of metastases is their multiplicity.

Fig.17.9 Metastases of cancer are in lungs

Penetration of tumour the masses in pulmonary tissue is takes place gematogenic, lymphogenic and by bronchogenic ways. In the case of gematogenic distribution tumour embols settle in the least vessels of lungs (arteriolas, capillaries,venulas ) and begin the development of metastases which are localised in the superficial departments of pulmonary parenchym (quite often subplevral). Roentgenological metastases show up as the rounded shades with clear hilly contours.

In the case of the lymphogenic skidding of tumour the masses lymphatic nodes are damaged round the roots of lungs and mediastinum which results in the tumour regeneration of lymphatic nodes.

Roentgenological pattern of metastatic defeat depends on the way of distribution of process. After a form they can be rounded, focular, interstitial, mixed. Metastases can appear in a different amount, in one or both lungs.

Lungs and pleurAl traumatic damages

The traumas of thorax are divided into: opened (penetrable) and closed (dull). On a method, causing first divide into gunshat, stab, cut, and second - as a result of blow, falling, clench. Victims grumble about pain in the area of breasts, stuffiness, and hyperhidrosis. The pallor of skin, tachycardia, appears during a review, painless in the damaged place, there can be a hemorrhage and hypodermic emphysema, acute respiratory insufficiency, shock.

Traumas which are accompanied the break of ribs are often complicated as a result of break of pulmonary tissue, visceral pleura and hit of air in a pleura cavity. Air in a pleura cavity can get and from outside through a wound. Roentgenological at pneumothorax the brightening and the lung pattern absence appear in the damaged half of thorax for peripheries.

Fig.17.10 pneumothorax (1, 2), hypodermic emphysema (3)

In the case of opened pneumothorax air can spread between soft tissues of the thorax and there is hypodermic emphysema which clinically detection appears by palpation, and roentgenological - by appearance of "feather-like" pattern at the lungs level as the result of muscles stratification of by air.

Often pneumothorax is accompanied by the break of vessels, hemorrhage in a pleura cavity and origin of hemopneumothorax. Roentgenologicaly in the superior departments of the damaged half of thorax brightening appears with absence of the lung pattern, and in homogeneous shade with a gorizontal level which remains such in any position of body.

Spontaneous pneumothorax can be as a result of complications of different lungs diseases (tuberculosis, emphysema, and cyst) from involvement in the pathological process of visceral pleura and its break.

Pneumothorax is better diagnosed by CT, which can find out even the small quantity of air in any pleura recesss (vertebro-mediastinal recess), and also air which got in mediastinum through the torn bronchus and spreads for peribronchial and perivascular spaces.