Pulmonary metastases u Lung is the most metastatic organ for malignant tumors 10-20% are limited or isolated u Route Direct infiltration and spread u Often primary in soft tissue of chest wall, pleura, mediastinum, or diaphragm u Esophageal, cardia, breast cancer Airway metastases Lymphatic metastases Bloodstream metastases u Multiple small nodules in lungs after treatment of primary tumor Smooth margins, scattered up and down both lungs, uniform density If single, examine brain, abdomen, bones, puncture biopsy if necessary u 15-20% primary lung cancer, double or multiple primary cancers u Primary squamous carcinoma, still primary tumor in the lung u Primary adenocarcinoma, primary and metastatic carcinoma each account for about 50% u Primary sarcoma, most tumors in the lung are metastases