metrizamide and Carcinoma--Small-Cell

Twenty patients suspected of meningeal carcinomatosis (MC) secondary to small cell carcinoma of the lung were evaluated by myelography and by cytologic examination of cerebrospinal fluid (CSF). In 4 patients both investigations demonstrated MC. Four had positive cytology but a negative myelogram. Five patients had a positive myelogram but negative cytology. Thus 13 of the 20 patients had MC diagnosed by one or both of these investigations. Two additional patients suspected of MC were studied; both had positive myelography, but cytologic examination of CSF was not performed in either case. Six patients underwent autopsy with microscopic examination of the spinal cord; in all cases post-mortem findings supported myelographic findings. In conclusion, myelography is useful in the evaluation of patients suspected of MC secondary to small carcinoma of the lung and complements the diagnostic role of CSF examination.

Topics: Carcinoma, Small Cell; Diagnosis, Differential; Humans; Lung Neoplasms; Meningeal Neoplasms; Metrizamide; Myelography

Solitary intramedullary metastasis to the spinal cord is rare and difficult to diagnose clinically. We report a case of lung carcinoma metastasizing to cervical spinal cord with an unusual feature of delayed metrizamide enhancement of the widened portion of the spinal cord. The role of CT in the diagnosis is well demonstrated in this case.

Topics: Carcinoma, Small Cell; Humans; Male; Metrizamide; Middle Aged; Myelography; Spinal Cord Neoplasms; Time Factors; Tomography, X-Ray Computed