Lymphangitic carcinomatosis (LC) refers to the diffuse infiltration and obstruction of pulmonary parenchymal lymphatic channels by tumor. Various neoplasms can cause lymphangitic carcinomatosis, but 80% are adenocarcinomas.
Etiolology:
occurs as a result of the initial hematogenous spread of tumor to the lungs, with subsequent malignant invasion through the vessel wall into the pulmonary interstitium and lymphatics. Tumor then proliferates and easily spreads through these low-resistance channels. Less commonly, direct infiltration occurs as a result of contiguous mediastinal or hilar lymphadenopathy or an adjacent primary bronchogenic carcinoma.
Histopathologic examination reveals interstitial edema, tumor cells, and interstitial fibrosis secondary to a desmoplastic reaction as a result of tumor extension into adjacent pulmonary parenchyma. Metastatic adenocarcinoma accounts for 80% of cases.
Manifestations:
the usual presenting complaint is breathlessness. Occasionally, patients may have a dry cough or hemoptysis. Symptoms often precede the development of any radiographic abnormality.
Typical radiographic appearance of lymphangitic carcinomatosis in a patient with breathlessness. Diffuse, bilateral reticulonodular opacification shown below:
MacDonald, Sumaira and Nawaz Khan, Ali. 2008. Lymphangitic Carcinomatosis. Retrieved January 6, 2010 from http://emedicine.medscape.com/article/359006-overview
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