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Lymphangitis carcinomatosis

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Known oseophageal malignancy with palliative stenting. Increasing shortness of breath. Normal WCC.

Patient Data

Age: 75 years
Gender: Male
x-ray

Distal esophageal stent. Bilateral diffuse increased reticular markings throughout both lungs. Tiny right sided pleural effusion.

Diagram

Illustrative explanation by Dr F Gaillard.

Case Discussion

Lymphangitic carcinomatosis is the term given to tumor spread through the lymphatics of the lung. It is most commonly seen secondary to adenocarcinoma, as in this case with an esophageal primary. The appearances on chest x-ray are those of reticulonodular shadowing. CT is much more sensitive.

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