Metastatic routes in lung cancer
Károlyi, P.
Orvosi Hetilap 129(34): 1805-6 1809-10
1988
ISSN/ISBN: 0030-6002 PMID: 3174118 Document Number: 320825
Distribution of metastases in 1607 autopsied cases was examined according to number of metastatic localisations. Based on these investigations 3 successive and distinctive metastatic stages can be separated in the course of the disease, as follows: 1. direct lymphogenic spread (towards the regional lymph nodes); 2. direct hematogenic spread (towards the liver, kidneys, bones, brain, etc); 3. terminal hematogenic dissemination (heart, skin, thyroid gland, etc.). Dynamics of direct spread to the pericardium and pleura or of secondary lymphogenic spread to distant lymph nodes is similar to that of direct hematogenic spread. The mode of metastasis can be different from the delineated one, e.g. appearance of lymph node metastases sometimes can be preceded by direct hematogenic spread. Appearance of cutaneous metastases is a clinical sign of terminal hematogenic dissemination which indicates poor prognosis.