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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Case report

Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review

Authors: Yikuan Feng, Jianping Zhao, Qun Yang, Weining Xiong, Guohua Zhen, Yongjian Xu, Zhenxiang Zhang, Huilan Zhang

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

In the lung, melanoma is mostly arranged as patterns of multiple nodules, solitary nodules, or miliary invasions. Very rarely, it also displays a “crazy paving” pattern (also described as a “paving stone,” “flagstone,” or “slabstone” pattern), which is rarer still in discrete bilateral nodules. This pattern is considered to be caused by pulmonary alveolar proteinosis, but its association with various diseases is unclear.

Case presentation

A 60-year-old man was diagnosed with pulmonary melanoma. Computed tomography revealed discrete bilateral nodules surrounded by a “paving” pattern. A literature review found more than 40 types of diseases that have presented with “paving” patterns in the lung—predominantly pulmonary alveolar proteinosis, viral pneumonia, exogenous lipoid pneumonia, bacterial pneumonia, pulmonary alveolar microlithiasis, interstitial pneumonia, ARDS, squalene aspiration pneumonia, radiation pneumonitis, drug-induced pneumonitis, pulmonary leptospirosis, pulmonary hemorrhage, and pulmonary nocardiosis.

Conclusions

We describe the first case of pulmonary melanoma in the form of discrete bilateral nodules accompanied with a computed tomography paving pattern. Although pulmonary paving patterns are rare, more than 40 diseases reportedly display them; clinicians should consider melanoma of the lung in differential diagnoses for patients who show such a pattern.
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Metadata
Title
Pulmonary melanoma and “crazy paving” patterns in chest images: a case report and literature review
Authors
Yikuan Feng
Jianping Zhao
Qun Yang
Weining Xiong
Guohua Zhen
Yongjian Xu
Zhenxiang Zhang
Huilan Zhang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2630-5

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