Distribution patterns of the metastases of the lung carcinoma in relation to histological type of the primary tumor: An autopsy study.

INTRODUCTION: Lung cancer is among leading causes of death worldwide. Different histological types of the lung carcinoma show significant differences in behavior.

OBJECTIVES: The aim of this study is to determine the distribution patterns of metastases of different lung cancer histological types in autopsied individuals.

METHODS: Protocols from all autopsies performed at the Institute of Pathology from 2008 till 2014 were reviewed retrospectively, and information on individuals' age, sex, histological type of primary lung cancer, presence and location of metastases, and causes of death were recorded.

RESULTS: More than 90% of the individuals with lung cancer metastases were older than 50 years (mean age: 64.5 ± 10.3), with two-fold male predominance. The most frequent histological type in both sexes was adenocarcinoma (48%). Although, in general, hematogenous metastases were mostly found in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Metastases in adrenal glands derived mostly from adenocarcinoma and large-cell carcinoma. Metastases in the intestines most frequently originated from large-cell carcinoma ( P = 0.01). Metastatic complications and bronchopneumonia were the most frequent causes of death.

CONCLUSIONS: While, overall, the most frequent hematogenous metastases occur in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Knowing distribution of metastases is essential for making algorithms of treatment, as well as for improving clinical assessment of the patients with unclear clinical findings and suspicion on occult primary lung cancer.