Presentation
Postmenopausal patient. Chest x-ray showed ill-defined densities. She denied any respiratory symptoms.
Patient Data
Multiple predominantly solid pulmonary nodules randomly distributed through both lungs, some of which with central cavitation. The lung parenchyma is otherwise unremarkable.
Case Discussion
The findings are highly concerning for metastatic hematogenous spread of unknown primary.
Primary lung carcinomas cavities more frequently than metastatic lesions in the lung. Most cavitary metastases are epithelial in origin.
This patient was not septic, making septic pulmonary emboli a less likely differential. The appearances are not those usually seen in cavitated lesions of granulomatosis with polyangiitis.
Unfortunately, no further clinical details were available for this case.