The incidence of osseous involvement in lung cancer, with special reference to the development of osteoblastic changes.

Radiographic analysis of the osseous system was performed in 110 consecutive patients with bronchogenic carcinoma. Thirty-eight had radiographic evidence of bone involvement, predominantly osteolytic. Nine (8.2%) demonstrated osteoblastic changes which were correlated to cell type, bone-marrow examination, 85Sr bone scan, and bone pathology. These results indicate that (a) squamous-cell and anaplastic large-cell carcinoma of the lung are the primary causes of local destructive lesions, and (b) small-cell and adenocarcinoma of the lung are commonly associated with diffuse bone-marrow invasion, sometimes leading to radiographically visible osteoblastic metastases.