Subpleural Lymphatic Permeation in Colorectal Lung Metastases

Abstract

A 71-year-old woman with a history of rectal cancer 2 years earlier was referred to our department to manage bilateral pulmonary nodules. A chest computed tomography scan showed one lung nodule in the right S1 (13 mm) segment and two nodules in the left S9 (30 mm) and left S10 (10 mm) segments. After resection of the right tumor, a wedge resection was scheduled for the left tumors. However, rosarylike structures were noted beneath the visceral pleura to the hilum (Figures 1A-1C, arrows). We suspected lymphatic invasion; hence, partial resection was considered inappropriate for R0 resection.