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Corredor-Orlandelli D, Vargas L. Lymphangitic carcinomatosis as the initial manifestation of primary signet-ring cell adenocarcinoma of the lung: A case report. Rare Tumors 2023; 15:20363613231164017. [PMID: 36937819 PMCID: PMC10014970 DOI: 10.1177/20363613231164017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/28/2023] [Indexed: 03/15/2023] Open
Abstract
Signet-ring cell carcinomas are an aggressive, poorly differentiated, and highly invasive adenocarcinoma carrying a poor prognosis. Most of these tumors originate in gastrointestinal organs; however, primary lung signet-ring cell adenocarcinomas can rarely occur. Tumoral lymphatic infiltration is a complication of these tumors and can cause phenomena such as lymphangitic carcinomatosis, characterized by a nodular thickening of the pleura, pleural effusions, and mediastinal lymphadenopathies. We report a case of a 63-year-old ex-smoker with a 2-week clinical course of dyspnea and pleuritic chest pain in which a nodular thickening of the pleura and pleural effusion were documented and led to the diagnosis of a primary signet-ring cell adenocarcinoma of the lung with lymphangitic carcinomatosis. This complication has never been described in the context of a primary lung tumor of this subtype. Both entities carry a high mortality and have no therapeutical options. This report adds to the information available about them.
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Affiliation(s)
- David Corredor-Orlandelli
- School of Medicine and Health
Sciences, Universidad del Rosario, Bogotá, Colombia
- David Corredor-Orlandelli, School of
Medicine and Health Sciences, Universidad del Rosario, Carrera 24 #63C-69,
Bogotá 110111, Colombia.
| | - Lina Vargas
- Internal Medicine Department, Fundación Cardioinfantil -
LaCardio, Bogotá, Colombia
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Im Y, Lee H, Lee HY, Baek SY, Jeong BH, Lee K, Kim H, Kwon OJ, Han J, Lee KS, Ahn MJ, Kim J, Um SW. Prognosis of pulmonary lymphangitic carcinomatosis in patients with non-small cell lung cancer. Transl Lung Cancer Res 2022; 10:4130-4140. [PMID: 35004244 PMCID: PMC8674602 DOI: 10.21037/tlcr-21-677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/25/2021] [Indexed: 12/25/2022]
Abstract
Background The eighth edition of the TNM classification for lung cancer does not provide a definite guideline for pulmonary lymphangitic carcinomatosis. The purpose of this retrospective case-control study is to evaluate the prognosis of pulmonary lymphangitic carcinomatosis in patients with non-small cell lung cancer compared with those with intrapulmonary metastases. Methods Non-small cell lung cancer (NSCLC) patients with pulmonary lymphangitic carcinomatosis detected on chest computed tomography scan during staging evaluation between 2000 and 2016 were included. The extent of pulmonary lymphangitic carcinomatosis was classified as being around the primary tumor (cLy1), at a distance from the tumor but confined to the same lobe (cLy2), in other ipsilateral lobes (cLy3), or affecting the contralateral lung (cLy4). Overall survival rates of the subjects were compared with those with intrapulmonary metastases. Results A total of 103 subjects with pulmonary lymphangitic carcinomatosis were analysed. The 5-year overall survival rates of the subjects with pulmonary lymphangitic carcinomatosis (n=103) and intrapulmonary metastases (n=111) were 33% and 21%, respectively. The 5-year overall survival rates of cLy1 (n=28), cLy2 (n=40), cLy3 (n=26) and cLy4 (n=9) were 54%, 35%, 12% and 11%, respectively. On multivariable analyses after adjusting for possible confounders, the subjects with cLy1 and cLy2 had better overall survival (adjusted hazard ratio for death, 0.34 and 0.49; 95% confidence interval, 0.24-0.73 and 0.30-0.80; P<0.001 and 0.004, respectively) and the subjects with cLy4 had worse overall survival (adjusted hazard ratio, 2.21; 95% confidence interval, 1.03-4.70; P=0.040) compared with those with intrapulmonary metastases. Conclusions The subjects with cLy1/2 had better overall survival than those with cLy3/4 or intrapulmonary metastases. cLy1/2 seems to be a T descriptor (T3/4) rather than an M1 descriptor.
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Affiliation(s)
- Yunjoo Im
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyewon Lee
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sun-Young Baek
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungjong Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - O Jung Kwon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joungho Han
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung Soo Lee
- Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jhingook Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Won Um
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
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Klimek M. Pulmonary lymphangitis carcinomatosis: systematic review and meta-analysis of case reports, 1970-2018. Postgrad Med 2019; 131:309-318. [PMID: 30900501 DOI: 10.1080/00325481.2019.1595982] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pulmonary lymphangitis carcinomatosis (PLC) is a life-threating complication in patients suffering from malignancies. Misleading and nonspecific symptoms often result in a delayed diagnosis. This review was aimed at evaluating epidemiology, clinical manifestations, and survival of patients with PLC reported in the literature. According to our knowledge, this study is the first such extensive analysis of PLC. We searched for the literature in the PubMed database for articles published from 1970 to 2018 using keywords: lung, pulmonary, lymphangitic, carcinoma, carcinomatosis. Pulmonary lymphangitis carcinomatosis rarely occurs, thus all data were extracted from case reports and case series consisted of a method for identifying individual-level patient data. In the final analysis, 108 articles (139 individual patient cases) were included. The mean age of PLC occurrence is 49.21 years. There is no difference in the prevalence between men and women. The most common underlying primary tumors coexisting with PLC are breast (17.3%), lung (10.8%), and gastric cancers (10.8%). Dyspnea and dry cough were the most common symptoms occurring in 59.0% and 33.8% of patients, respectively. In half the patients, PLC developed in fewer than ten months after first diagnosis of cancer. Pulmonary lymphangitis carcinomatosis diagnosis is associated with a poor prognosis: approximately half of patients die within two months of their first respiratory symptoms and three weeks from admission to hospital. Regarding survival time, we observed better results achieved in patients described between 2000 and 2018 compared to 1970 through 1999. In the presence of progressive dyspnea, cough, and lesions comparable to interstitial lung disease, diagnosis of PLC should be considered. Pulmonary lymphangitis carcinomatosis can be the first manifestation of primary occult neoplasm and may occur at any age. Adenocarcinoma, especially primary lung, breast, and gastric cancers is the most common cancer coexisting with PLC.
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Affiliation(s)
- Monika Klimek
- a Department of Laboratory Diagnostics , Medical University of Lublin , Lublin , Poland
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Okayama M, Kanemitsu Y, Oguri T, Asano T, Fukuda S, Ohkubo H, Takemura M, Maeno K, Ito Y, Niimi A. A Rare Case of Isolated Chronic Cough Caused by Pulmonary Lymphangitic Carcinomatosis as a Primary Manifestation of Rectum Carcinoma. Intern Med 2018; 57:2709-2712. [PMID: 29780119 PMCID: PMC6191591 DOI: 10.2169/internalmedicine.0572-17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A 36-year old man was referred to our hospital due to isolated chronic cough that was refractory to anti-asthma medications, including inhaled corticosteroids/long-acting β2 agonists. Chest X-ray showed diffuse nodular and enhanced vascular shadows with Kerley lines in both lungs. A blood analysis showed elevated serum carcinoembryonic antigen (CEA) and CA19-9 levels. A transbronchial biopsy revealed well to moderately differentiated adenocarcinoma, the origin of which was immunohistochemically suspected to be the gastrointestinal tract. Colonoscopy confirmed the diagnosis of primary rectum carcinoma. Pulmonary lymphangitic carcinomatosis was therefore regarded as the origin of the cough. Lymphangitic carcinomatosis is an uncommon diagnosis but important to consider in patients with persistent cough.
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Affiliation(s)
- Minami Okayama
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Tetsuya Oguri
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Takamitsu Asano
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Satoshi Fukuda
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Hirotsugu Ohkubo
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Masaya Takemura
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Ken Maeno
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Yutaka Ito
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Japan
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Jinnur PK, Pannu BS, Boland JM, Iyer VN. Occult pulmonary lymphangitic carcinomatosis presenting as 'chronic cough' with a normal HRCT chest. Ann Med Surg (Lond) 2016; 6:77-80. [PMID: 26958342 PMCID: PMC4764654 DOI: 10.1016/j.amsu.2016.01.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 01/07/2016] [Accepted: 01/18/2016] [Indexed: 11/28/2022] Open
Abstract
A diagnosis of ‘chronic cough’ (CC) requires the exclusion of sinister pulmonary pathology, including infection and malignancy. We present a patient with a 3 month history of CC who had an extensive workup including a normal high resolution computed tomography of the chest (HRCT) 6 weeks prior to consultation at our center. He subsequently developed constitutional symptoms including weight loss and loss of appetite 5 weeks after initial consultation. A repeat HRCT chest and a subsequent whole body PET scan found that he had developed extensive pulmonary lymphangitic carcinomatosis (PLC) from a colon primary. Treatment of the colon cancer resulted in significant decrease in metastatic disease burden and cough resolution. PLC is a very rare cause of ‘chronic cough’ and incipient/occult PLC presenting with chronic cough and a normal initial HRCT chest has not been previously reported. Asthma, GERD and postnasal drip are the 3 most common causes of chronic cough. Constitutional symptoms (weight loss etc.) never occur in chronic cough. Pulmonary lymphangitic carcinomatosis can rarely present with chronic cough.
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Affiliation(s)
- Praveen K Jinnur
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Bibek S Pannu
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jennifer M Boland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vivek N Iyer
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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Podgrabinska S, Skobe M. Role of lymphatic vasculature in regional and distant metastases. Microvasc Res 2014; 95:46-52. [PMID: 25026412 DOI: 10.1016/j.mvr.2014.07.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 07/07/2014] [Indexed: 11/16/2022]
Abstract
In cancer, lymphatic vasculature has been traditionally viewed only as a transportation system for metastatic cells. It has now become clear that lymphatics perform many additional functions which could influence cancer progression. Lymphangiogenesis, induced at the primary tumor site and at distant sites, potently augments metastasis. Lymphatic endothelial cells (LECs) control tumor cell entry and exit from the lymphatic vessels. LECs also control immune cell traffic and directly modulate adaptive immune responses. This review highlights advances in our understanding of the mechanisms by which lymphatic vessels, and in particular lymphatic endothelium, impact metastasis.
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Affiliation(s)
- Simona Podgrabinska
- Department of Obstetrics, Gynecology & Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mihaela Skobe
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute at Mount Sinai, New York, NY 10029, USA.
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7
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Tighe D, Cavilla S, Simcock R. Pulmonary lymphangitic carcinomatosis from head and neck squamous cell carcinoma. Int J Oral Maxillofac Surg 2014; 43:806-10. [DOI: 10.1016/j.ijom.2013.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 12/12/2013] [Accepted: 12/18/2013] [Indexed: 11/25/2022]
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9
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Lymphangitis carcinomatosa: report of a case and review of literature. Indian J Surg Oncol 2011; 1:274-6. [PMID: 22693377 DOI: 10.1007/s13193-011-0047-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 01/30/2011] [Indexed: 10/18/2022] Open
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Suter PF, Carrig CB, O'Brien TR, Koller D. Radiographic Recognition of Primary and Metastatic Pulmonary Neoplasms of Dogs and Cats1. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1740-8261.1974.tb00681.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Adams WM, Dubeilzig R. Diffuse Pulmonary Alveolar Septal Metastases from Mammary Carcinoma in the Dog. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1740-8261.1978.tb01157.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Affiliation(s)
- J W Wu
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1088, USA
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Honda O, Johkoh T, Ichikado K, Yoshida S, Mihara N, Higashi M, Tomiyama N, Maeda M, Hamada S, Naito H, Takeuchi N, Yamamoto S, Nakamura H. Comparison of high resolution CT findings of sarcoidosis, lymphoma, and lymphangitic carcinoma: is there any difference of involved interstitium? J Comput Assist Tomogr 1999; 23:374-9. [PMID: 10348442 DOI: 10.1097/00004728-199905000-00010] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE The purpose of this study was to determine distinguishing features of three diseases that are distributed along the lymphatics. METHOD CT scans of 40 patients with lymphangitic carcinomatosis, 41 with sarcoidosis, and 44 with malignant lymphoma were retrospectively reviewed. We evaluated the degree of involvement of the interlobular septa, bronchovascular structures, subpleural interstitium, and other CT findings. RESULTS The number of thickened interlobular septa and the extent of involvement of the subpleural interstitium in lymphangitic carcinomatosis were higher than those in sarcoidosis and malignant lymphoma (p<0.0001). Nodules of >1 cm in diameter were more often seen in malignant lymphoma (41.0%) than in the other two diseases (p < 0.001). Bilateral distribution was more common in sarcoidosis (100%) than in the others (p<0.001). CONCLUSION The major difference among lymphangitic carcinomatosis, sarcoidosis, and malignant lymphoma is the greater involvement of the interlobular septa and subpleural interstitium in lymphangitic carcinomatosis than in either sarcoidosis or malignant lymphoma.
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Affiliation(s)
- O Honda
- Department of Radiology, Osaka University Medical School, Suita, Japan
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Hirakata K, Nakata H, Nakagawa T. CT of pulmonary metastases with pathological correlation. Semin Ultrasound CT MR 1995; 16:379-94. [PMID: 8527171 DOI: 10.1016/0887-2171(95)90027-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
CT, including high-resolution CT, has become an essential means of imaging to evaluate pulmonary metastases. The underlying pathological processes of pulmonary metastases can be observed well on CT images, but they are not always specific. Several important CT features correlate with histopathological findings: (1) margin of nodule; (2) hemorrhage accompanying a metastatic nodule; (3) calcification; (4) cavitation; (5) sterilized metastasis; (6) small metastatic nodules in the lobules; (7) lymphangitic carcinomatosis; (8) tumor emboli; and (9) pleural metastases. For reasonable use of CT in pulmonary metastases, these various CT manifestations and their limitations must be understood.
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Affiliation(s)
- K Hirakata
- Department of Radiology, University of Occupational and Environmental Health, Kitakyushushi, Japan
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Computed Tomography in Chronic Interstitial Lung Disease. Radiol Clin North Am 1991. [DOI: 10.1016/s0033-8389(22)02106-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Carella MJ, Murray RH, de Mendonca-Calaca W. Diffuse pulmonary tumor microemboli from prostatic carcinoma with an associated fibrous histiocytic sarcoma. Am J Med Sci 1990; 299:107-12. [PMID: 2154098 DOI: 10.1097/00000441-199002000-00006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Diffuse tumor microemboli to the lungs from prostatic carcinoma are extremely rare, with only six reported cases in the literature published in English. Here a seventh case is reported. The patient resembled the previously reported cases in the following ways: (1) There were minimal chest x-ray findings; (2) there was no other evidence of significant parenchymal or lymphangitic tumor involvement; and (3) pulmonary hypertension developed, but without signs of cor pulmonale. The case was even more unusual because of the presence of an apparent second neoplasm, ie, a malignant fibrous histiocytic sarcoma primary in the chest wall. There were wide-spread "collisional metastases" (metastases from each malignancy at the same site).
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Affiliation(s)
- M J Carella
- Department of Medicine, College of Human Medicine, Michigan State University, East Lansing 48824-1317
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Filderman AE, Coppage L, Shaw C, Matthay RA. Pulmonary and Pleural Manifestations of Extrathoracic Malignancies. Clin Chest Med 1989. [DOI: 10.1016/s0272-5231(21)00662-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Muñoz Lucena F, Martinez Parra D, Rodriguez Panadero F, Peña Griñan N, Lopez Mejias J. Linfangitis carcinomatosa pulmonar. Correlaciones Clinico-morfologicas. Arch Bronconeumol 1984. [DOI: 10.1016/s0300-2896(15)32239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Technical advances have made the bedside measurement of colloid osmotic pressure (COP) a rapid and reproducible test. The principles of measurement are described and the place of COP determinations in the recognition, treatment and prophylaxis of oedematous states is discussed.
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Green N, Kern W, Levis R, Schleiter W, Bonorris J, Berne CJ. Lymphangitic carcinomatosis of the lung: pathologic, diagnostic and therapeutic considerations. Int J Radiat Oncol Biol Phys 1977; 2:149-53. [PMID: 849895 DOI: 10.1016/0360-3016(77)90021-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bachofen H, Voegeli E. Disseminated nodular and miliary lesions of the lung. PNEUMONOLOGIE. PNEUMONOLOGY 1976; 153:249-60. [PMID: 995706 DOI: 10.1007/bf02095366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
Pulmonary lymphangitic carcinomatosis, a grave complication of malignant neoplasms, usually progresses rapidly and is fatal despite all modes of therapy. We recently observed complete resolution of pulmonary lymphangitic involvement from an adenocarcinoma of the breast following both chemotherapy and bilateral oophorectomy. The patient's chest radiograph has remained clear for 1 1/2 years.
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Abstract
A combined radiological and autopsy study of pulmonary oedema enables recognition of oedema lines other than Kerley 'A', 'B' and C lines. These have been designated 'D' lines. At least three varieties have been noted: (i) thick, long often angular lines seen mainly anteriorly overlying the heart shadow on the lateral film. These may also appear as horizontal or vertical band shadows, on the frontal view. (ii) Short and straight lines, occurring basally and often slightly thicker at the pleural surface, which on autopsy lung radiographs are associated with puckering of the pleura. They have also been recognised on lateral films where they resemble the pleural end of a fissure but have been seen in positions where fissures do not mormally occur, or in addition to the normal fissure. (iii) A subpleural reticular pattern surrounding spaces 1-2 cm in diameter. This has been noted only on autopsy-inflated lungs and not detected on in vivo chest radiographs. The long 'D' lines or D(i) lines occur in areas where 'B' lines are inconspicuous or absent and vice versa. Whereas 'B' lines are most prominent in areas of macroscopic alveolar pulmonary oedema, D(i) lines occur where macroscopic alveolar pulmonary oedema is often inconspicuous. The recognition that lines other than 'A', B and 'C' occur in case of pulmonary oedema greatly assists in the interpretation and diagnosis of the shadows on chest radiographs associated with pulmonary oedema.
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THE DIFFERENTIAL DIAGNOSIS OF LINEAR SHADOWS IN CHEST RADIOGRAPHS. Radiol Clin North Am 1973. [DOI: 10.1016/s0033-8389(22)01966-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lymphangitis Carcinomatosa. BRITISH MEDICAL JOURNAL 1965; 1:811-812. [PMID: 20790480 PMCID: PMC2166238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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31
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Trapnell DH. The Use of X-rays as a Research Instrument [ Summary]. Proc R Soc Med 1965. [DOI: 10.1177/003591576505800307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Trapnell DH. Man's Understanding of the Lymphatics, with Particular Reference to the Lung. Proc R Soc Med 1965. [DOI: 10.1177/003591576505800110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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