An unusual presentation of malignant melanoma metastatic to the lungs and bronchi. Bilateral ground-glass opacities with a "crazy paving" component. Academic Article uri icon


  • A 51-year-old previously healthy man was admitted for evaluation of dry cough, dyspnea, and bilateral alveolar consolidations on chest radiography (Figure 1A). He denied fever or weight loss. A computed tomography (CT) scan of the chest revealed bilateral areas of ground-glass opacities in a central distribution, some with a component of “crazy paving” pattern, as well as intervening alveolar consolidations, and a marked sparing of both lungs' periphery (Figure 1B). Bronchoscopy revealed multiple black pigmented submucosal patches (Figure 1C). Examination of bronchoalveolar lavage fluid, bronchial brushings, and transbronchial biopsies from both lungs revealed numerous pigmented pleomorphic cells that were immunoreactive with S100 protein and the melanocytic markers human melanoma black-45 (HMB-45), melanoma antigen recognized by T cells-1 (MART-1), and tyrosinase …

publication date

  • January 1, 2015