Pulmonary lymphangitic carcinomatosis as a primary manifestation of gastric carcinoma in a young adult: A case report and review of the literature

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Abstract

Background: Lymphangitic carcinomatosis as a manifestation of gastric carcinoma is rare. The presenting symptoms are misleading and nonspecific, often resulting in delayed diagnosis. Case presentation. We present a case of a 24 year old male with progressive dyspnea. Initial radiologic assessment suggested interstitial lung disease, which was subsequently treated with antibiotics and corticosteroids. However, endoscopy and whole body diffusion-weighted magnetic resonance imaging revealed a metastatic gastric cancer with the presence of lymphangitic carcinomatosis. Conclusions: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic gastric cancer. Patients present with severe but non-specific respiratory complaints. Definitive diagnosis can be achieved by transbronchial biopsy. Prognosis is poor and optimal treatment is not defined. Whole body diffusion-weighted magnetic resonance imaging is a promising imaging tool for the diagnosis of metastatic gastric cancer. © 2012 Moubax et al.; licensee BioMed Central Ltd.

Figures

  • Figure 1 Chest X-ray at time of first admission shows diffuse diffuse reticulonodular pattern.
  • Figure 2 (A) High resolution computed tomography of the chest at time of first admission shows bilateral areas of ground-glass opacification and diffusely thickened interlobular septa. Moreover it showed the presence of hilar and mediastinal adenopathies. (B) Repeat scan after broad-spectrum antibiotics and high-dose corticosteroids shows progression of the interstitial disease.
  • Table 1 Blood results at first admission and in our hospital
  • Figure 3 (A,B) WB-DWI with b1000-images and T2-weighted images in the coronal plane shows a tumoral mass in the lesser curvature of the stomach (arrow), (C,D) with diffuse metastases in the lungs and mediastinum as well as skeletal metastases in a right-sided rib and right iliac wing (arrows).
  • Figure 4 (A,B) WB-DWI with b1000-images and T2-weighted images i tumour (arrow), (C,D) diffuse metastases in the lungs and mediastinu (arrows).
  • Table 2 common locations of primary tumours associated with pulmonary lymphangitic carcinomatosis (1)
  • Table 3 Radiologic characteristics of pulmonary lymphangitic carcinomatosis (6)

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Moubax, K., Wuyts, W., Vandecaveye, V., & Prenen, H. (2012). Pulmonary lymphangitic carcinomatosis as a primary manifestation of gastric carcinoma in a young adult: A case report and review of the literature. BMC Research Notes. https://doi.org/10.1186/1756-0500-5-638

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