Pulmonary lymphangitic carcinomatosis in the course of gastric cancer – Case report

Abstract

Pulmonary lymphangitic carcinomatosis is a special type of diffuse metastasis of carcinoma in the lymphatic vessels of the lungs. Lymphangitic carcinomatosis is commonly observed in malignancies of the breast, lung, pancreas, colon and cervix as a strong marker for poor prognosis. Presenting with common respiratory symptoms, it may be easily misdiagnosed as other pulmonary interstitial diseases. Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic gastric cancer. The presented case describes a patient with pulmonary lymphangitic carcinomatosis in the course of stomach cancer. The primary diagnosis was established based on the exclusion of other interstitial lung diseases, with the use of imaging techniques as well as biochemical, microbiological and cytological findings. The patient's general condition was very severe, rendering him bedridden and therefore not eligible for any treatment, including chemotherapy. He died suddenly before final verification of the diagnosis. Pulmonary lymphangitic carcinomatosis should be suspected in patients with advanced gastric cancer, presenting with symptoms and signs of respiratory disease. Imaging techniques are mostly helpful to establish the diagnosis.

Bard's Syndrome: A Rare Case Presentation of Pulmonary Miliary Metastases of Gastric Carcinoma

“…HRCT is the imaging technique of choice, it reveals thickening of interlobular septa, fissures and bronchovascular bundles, nodularity in pleura and ground glass opacity. They may be seen as limited or diffuse, unilateral or bilateral, symmetric or asymmetric infiltrates [8]. Pleural effusion can also be observed.…”

“…The differential diagnosis of diffuse interstitial lung changes should includ sarcoidosis, viral pneumonias, pulmonary oedema, radiation pneumonitis, drug-induced lung disease, miliary tuberculosis and lymphocytic interstitial pneumonia [8,9].…”