Metastatic Papillary Thyroid Carcinoma and Severe Airflow Obstruction

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Metastatic Papillary Thyroid Carcinoma and Severe Airflow Obstruction Christopher Manganaris, MD, Steven Wittlin, MD, Haodong Xu, MD, Michael Gurell, MD, Patricia Sime, MD, Robert Matthew Kottmann, MD CHEST Volume 138, Issue 3, Pages 738-742 (September 2010) DOI: 10.1378/chest.09-1961 Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 1 Metastatic papillary thyroid carcinoma involves the bronchiole with luminal occlusion. Hematoxylin and eosin stain of lung biopsy, original magnification, × 100 (A) and × 400 (B). Thin arrows indicate bronchiolar epithelium; large arrows demonstrate tumor invading and occluding the lumen. CHEST 2010 138, 738-742DOI: (10.1378/chest.09-1961) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 2 Flow-volume loops from spirometry performed in December 2004 and September 2008 show the development of severe obstructive lung disease. Rx = bronchodilator treatment. CHEST 2010 138, 738-742DOI: (10.1378/chest.09-1961) Copyright © 2010 The American College of Chest Physicians Terms and Conditions

Figure 3 Chest CT scan showing innumerable tiny bilateral pulmonary nodules consistent with metastatic papillary thyroid carcinoma (A). Chest CT scan 2 years later showing progression of metastatic disease (B). CHEST 2010 138, 738-742DOI: (10.1378/chest.09-1961) Copyright © 2010 The American College of Chest Physicians Terms and Conditions