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Vol. 59. Issue 4.
Pages 257 (April 2023)
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Vol. 59. Issue 4.
Pages 257 (April 2023)
Clinical Image
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Micronodular Lung Infiltration as a Manifestation of Metastatic Melanoma
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Pilar Barragán-Reyes
Corresponding author
barraganreyespilar@gmail.com

Corresponding author.
, Francisco Rodríguez Jerez
Servicio de Neumología, Hospital Universitario Clínico San Cecilio, Granada, Spain
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A 64-year-old female patient incomed into our Respiratory Ward with dyspnea, pleuritic chest pain and two black skin lesions on the right cheek and occipital region of recent development. Chest X-ray and computed tomography (CT) showed randomly distributed pulmonary micronodules in both fields (Fig. 1), with post-primary tuberculosis with bronchogenic dissemination as first diagnostic option.

Fig. 1.

Chest X-ray (left) and coronal section of CT (right) image showing randomly distributed pulmonary micronodules in both fields.

(0.06MB).

Bronchoscopy was performed with no microbiological findings and negative cytopathology for malignant cells so the patient underwent to rigid bronchoscopy with cryoprobe lung biopsy that showed bronchial and interstitial lung infiltration by malignant melanoma from metastatic origin probability. Biopsies of the skin lesions revealed superficial spreading melanoma with infiltration of the reticular dermis.

Lung metastases of malignant melanoma present different morphological patterns, being the most common the “solid pattern”.1 The case we present seems to be a very rare condition because the micronodular lung affectation pattern, as in our case, has been reported formerly only in an 8 patients serie in 1977 (to our knowledgment).2

Metastatic dissemination of cutaneous melanoma can be located in the skin, subcutaneous tissues, locoregional lymph, lymph nodes and distant organs or structures, being the lung the most frequently affected organ3 but usually not in the way of our patient.

Conflict of interests

The authors state that they have no conflict of interests.

References
[1]
M. Soliman, T. Petrella, P. Tyrrell, F. Wright, N.J. Look Hong, H. Lu, et al.
The clinical significance of indeterminate pulmonary nodules in melanoma patients at baseline and during follow-up chest CT.
Eur J Radiol Open, 6 (2019), pp. 85-90
[2]
W.R. Webb, G. Gamsu.
Thoracic metastasis in malignant melanoma. A radiographic survey of 65 patients.
Chest, 71 (1977), pp. 176-181
[3]
A. Briones Gómez, E. Cases Viedma, R. Doménech Clar, J.L. Sanchis Aldás.
Pulmonary metastases of malignant melanoma Infrequent endobronchial presentation.
Arch Bronconeumol, 35 (1999), pp. 455-457
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