We present a case of advanced pancreatic cancer with diffuse pulmonary interstitial infiltrates and dyspnea in a 61-year-old Asian Taiwanese female. Although surgical lung biopsy is the diagnostic gold standard in most interstitial lung disease, it frequently leads to complications in sick patients. Based on the overall clinico-radiologic correlation, a diagnosis of pulmonary lymphangitic carcinomatosis was supported by the characteristic findings in high-resolution computed tomography.

IntroductionPulmonary pneumatoceles are thin-walled, air-filled cysts that develop within the lung. Most often, they occur as a sequela to acute pneumonia, commonly caused by Staphylococcus aureus, and are found more frequently in infants and young children. Adult tuberculous pulmonary pneumatoceles are seldom reported.Case presentationWe reported a case of pulmonary tuberculosis with pneumatocele formation after antituberculous treatment. A 41-year-old man presented with fever and productive cough for 3 weeks. Chest X ray revealed cavitary lesions in bilateral upper lobes of the lung. Acid-fast rods were found in sputum and the cultures subsequently yielded Mycobacterium tuberculosis. After antituberculous treatment, obvious pneumatocele formation was noted in the right upper lobe.ConclusionThe formation of pneumatoceles in adult pulmonary tuberculosis can occur before, during or after antituberculous treatment, and the development of complications of pneumatoceles was variable.