Learning objectives
A brief review of the anatomy of the secondary pulmonary lobule and interstitial lung disease.
Expose and correlate the patterns and radiological signs of lymphangitic carcinomatosis (LC) in chest radiography as well as in the MDCT and the typical and atypical forms of presentation.
Show the differential diagnosis of this entity remarking the findings that will help us to differentiate this entity from another,
with a description of the most important semiological and clinical data.
Background
The lungs are one of the most common targets for metastatic disease.
Most pulmonary metastases are nodular,
but a significant minority is interstitial.
LC refers to the diffuse infiltration and obstruction of pulmonary parenchymal lymphatic channels by tumor,
which occurs in the 6-8% of cancers.
Various neoplasms can cause CL,
but 80% are adenocarcinomas.
The most common primary sites are the breasts,
lungs,
colon,
and stomach.
Radiographic characteristics of CL are presented in the images below.
Findings and procedure details
Introduction:
The term lymphangitis carcinomatosis (LC),
introduced by Troisier in 1873,
describes an entity that can be distinguished from the others because of its clinical and radiological presentation,
which is characterized by a diffuse infiltration of the pulmonary interstitial,
due to the dissemination of the malignant neoplastic cells in the lymphatic vessels of the lung.
However,
the first account of the pathological changes that occur in this condition,
in fact,
was published over 50 year earlier by the French physician,
Gabriel Andral in his major...
Conclusion
MDCT is the technique of choice for study in patients with suspected LC.
Its diagnosis requires a clinical context that includes neoplastic disease.
Although the fateful prognosis,
the radiologist must quickly recognize the imaging findings to give the patient the most suitable treatment.
References
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Huang Y.[Clinical features and diagnosis of pulmonary lymphangitic carcinomatosis]..Ai zheng = Aizheng = Chinese journal of cancer.2006 Sep;25(9):1127-30
Diagnostic Imaging: Chest,
First Edition.
Gurney,
Jud W.,
MD,
FACR
Trapnell DH: Radiological appearance of lymphangitis carcinomatosa of the lung.
Ren H et al: Computed tomography if inflation-fixed lungs: the beaded septum sign of pulmonary metastases.
J Comput Assist Tomogr 13:411-6.
Hominal S,
Falchero L,
Perol M,
Guérin JC.[Carcinomatous lymphangitis]..Presse medicale (Paris,
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