Atypical Pulmonary Metastases: Patterns and Clinical Significance

Pulmonary metastases are most commonly hematogenous in origin and typically appear as multiple peripheral, well-defined, variable-sized nodules with or without lymphatic interstitial thickening. The authors review atypical pulmonary metastases-that is, metastases that are atypical by virtue of their morphology, location, evolution over time, or primary tumor origin. The clinical significance of the different appearances and anatomic variations of these metastatic tumors is also discussed. Knowledge of the imaging features of atypical pulmonary metastases can sometimes help prevent misinterpretation of findings. ^©RSNA, 2025 See invited commentary by Baruah and Kabakus in this issue.