PMC3988609_01
57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Posteroanterior chest radiograph demonstrates complete collapse of left lung, pathologic fracture of left sixth rib (arrow), and destructive mass (arrowhead) involving the right posterior fifth rib.
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F1
Chest radiograph revealed a collapsed left lung, pathologic fracture of the left sixth rib, and a destructive mass involving the right posterior fifth rib [Figure 1].
57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Non-enhanced CT of the chest. Axial CT images at a mid level in the chest in (a) lung window and (b) soft tissue window show a hyperdense mass (arrow) in the left main bronchus with postobstructive collapse and leftward mediastinal shift. (c) Axial CT image of a lower level in the chest demonstrates an additional hyperdense lobulated left lower lobe mass (arrow). (d) Coronal CT image shows a lytic lesion in a thoracic vertebra (arrow).
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F2
Non-Enhanced CT (NECT) of the chest showed a hyperdense mass with a mean density of 56 Hounsfield units within the left main bronchus, resulting in postobstructive left lower lobe collapse [Figure 2a and b]. In addition, there were two hyperdense left lower lobe intraparenchymal masses, one of which was lobulated [Figure 2c]. There were also lytic bone lesions in the right scapula (not shown) and thoracic vertebrae [Figure 2d].
57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Contrast-enhanced axial CT image through the lower chest demonstrates heterogeneous enhancement of the left lower lobe mass (arrow).
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F3
Contrast-enhanced CT (CECT) through the lower chest demonstrated heterogeneous enhancement of the left lower lobe masses [Figure 3].
57-year-old man presenting with dyspnea and black-colored sputum diagnosed with endobronchial metastasis from melanoma. Microscopic findings: Staining of endobronchial biopsy specimen with hematoxylin and eosin shows pigment-laden cells, indicative of metastatic melanoma (x400).
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F4
Bronchoscopy revealed a black-colored hemorrhagic endobronchial mass that was confirmed on histopathology to be an endobronchial metastasis from melanoma [Figure 4].