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Open Access Highly Accessed Case Report

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

Kim Moubax1, Wim Wuyts2, Vincent Vandecaveye3 and Hans Prenen1*

Author Affiliations

1 Department of Gastroenterology, University Hospitals Leuven, Digestive Oncology Unit, Herestraat 49, 3000, Leuven, Belgium

2 Department of Pneumology, University Hospitals Leuven, Leuven, Belgium

3 Department of Radiology, University Hospitals Leuven, Leuven, Belgium

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BMC Research Notes 2012, 5:638  doi:10.1186/1756-0500-5-638

Published: 16 November 2012

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.

Keywords:
Lymphangitic carcinomatosis; Gastric cancer; Whole body MRI