Pulmonary lymphangitic carcinomatosis without concurrent liver metastasis from colon cancer detected using 18F-FDG PET/CT: A case report

Medicine (Baltimore). 2019 Oct;98(41):e17446. doi: 10.1097/MD.0000000000017446.

Abstract

Rationale: The infiltration of tumor cells to pulmonary lymphatic system, as known as pulmonary lymphangitis carcinomatosis (PLC), is a rare presentation of pulmonary metastases.

Patient concerns: We reported a case of a 66-year-old man after surgery, chemotherapy, and radiation therapy for colon cancer. Two months after these therapies, the patient complained of nonproductive cough for 1 week.

Diagnoses: 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scanning revealed increased FDG uptake along the thickened bronchovascular bundles, in bilaterally scattered ground-glass opacities and in mediastinal lymphadenopathy. The transbronchial biopsy and pathological study confirmed the diagnosis of PLC.

Interventions: Antineoplastic treatment (cetuximab) were administered after the patient was diagnosed with PLC.

Outcomes: The patient died of respiratory failure within 3 months after the onset of his symptom.

Lessons: 18F-FDG PET/CT play an important role in identifying PLC, in selecting possible biopsy sites, and in accessing the extent of metastatic disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma / diagnostic imaging*
  • Carcinoma / secondary
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / diagnostic imaging*
  • Colonic Neoplasms / pathology
  • Fluorodeoxyglucose F18
  • Humans
  • Lung / diagnostic imaging
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / secondary
  • Lymphangitis / diagnostic imaging*
  • Lymphangitis / etiology
  • Male
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18