| The clinical manifestations of the five cases of lymphangitic carci-nomatosis of the lung presented as diffuse and interstitial disease . |
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Young Joo Sung, Soo Jeon Choi, Bong Chun Lee, Dong Soon Kim, Yeon Lim Seo |
1Department of Internal Medicine, Inje University, College of Medicine, Seoul, Korea
2Department of Clinical Pathology, , Inje University, College of Medicine, Seoul, Korea |
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| Abstract |
Background
The lung is the most common site of metastasis and usually it manifests as a single or multiple nodules in chest X.ray. But less commonly the cancer spreads through the lymphatics and X.ray shows diffuse reticulonodular densities. Sometimes, patient is presented with respiratory symptoms only with interstitial lung infiltration before the signs of primary tumor and in that cases, the differential diagnosis with other interstitial lung disease is required. We have experienced 5 such cases, who were diagnosed as lymphangitic carcinomatosis by transbronchial lung biopsy.
Methods
Clinical manifestation, pulmonary function test, modified thin section CT, bronchoalveolar lavage and transbronchial lung biopsy were done.
Results
The primary tumor was gastric cancer in 3, lung cancer in 2. Pulmonary function test showed restrictive pattern with low DLco in 2 patients and obstructive pattern in one. Bronchoalveolar lavage showed lymphocytosis in 4 patients and malignant cells were found in one patient. Transbronchial lung biopsy revealed malignant cells localized to the lymphatics (peribronchial, perivascular, and perialveolar). Cell type was adenocarcinoma in 4 and squamous cell carcinoma in one.
Conclusion
Rarely lymphangitic carcinomatosis can be presented as diffuse interstitial lung disease and easily diagnosed by transbronchial lung biopsy |
| Key Words:
Lymphangitic carcinomatosis, Lung, Transbronchiallung biopsy, Lung cancer, Stomach cancer, Bronchoalveolar lavage |
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