Hemorrhagic pulmonary metastases are those which tend to be complicated by pulmonary hemorrhage within them, resulting in characteristic imaging appearances. Metastases of some tumor histologies are more likely to hemorrhage -- knowledge of this can help refine the differential diagnoses.
Hemorrhage is mostly thought to be due to fragility of neovascular tissue that leads to a rupture of the vessel.
Recognized types generally tend to have high vascularity within them and include 1-2
- angiosarcoma - metastatic angioscarcoma to the lungs
- choriocarcinoma - metastatic choriocarcinoma to the lungs
- renal cell carcinoma
If there is a peri-tumoral hemorrhage this may be seen as a nodule or mass which is surrounded by a halo of ground-glass opacity (CT halo sign) or an ill-defined fuzzed out margin.
For a suspected nodule or mass giving a CT halo sign - see differential for a CT halo sign.
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