Case Report

Delays in Diagnosis of Pulmonary Lymphangitic Carcinomatosis due to Benign Presentation

Table 1

Case reports of PLC suspected as an ILD.

S. NO1234567891011121314
Age/gender15
F
7
M
31
F
45
F
53
F
63
M
62
F
62
M
39
F
24
M
30
M
30
M
25
M
62
M
SymptomsCough, sob, lethargy, satiety, anorexiaRespiratory distressDry cough, dyspneaDry coughProductive cough and dyspneaProgressive dyspnea and coughProgressive dyspnea, weight loss, and rash.Worsening dyspneaDyspnea, dry cough.Dry cough, night sweats, dyspnea hemoptysisDry cough, night sweats, dyspnea on exertion, weight lossCough, sob, fever, and chest pain.Cough, dyspnea on exertionDyspnea, dry cough fever for six weeks
Chest CTThickened interlobular septaMediastinal lymphadenopathy, B/l interstitial infiltratesMediastinal lymphadenopathy. Thickened interlobular septa, ground-glass opacitiesInterlobular septal thickening, scattered GGO, nodularity along fissures,Interstitial thickening, crazy paving, mediastinal lymphadenopathyEnlarged med LN, diffuse reticular thickening, reticular-nodular pattern.Diffuse reticulonodular and ground-glass opacities, pleural effusionsSubpleural reticulations pulmonary nodules, enlarged mediastinal LNInterstitial and ground-glass opacities. Borderline mediastinal lymphadenopathyGround glass opacities, diffusely thickened interlobular septa, mediastinal and hilar LN enlargedThickening of peribronchovascular, interstitial, and interlobular septa. Ground glass opacitiesMediastinal lymphadenopathy and reticulonodular interstitial pattern.Diffuse interstitial prominenceBilateral interstitial infiltrates
DiagnosticsOpen lung biopsyOpen lung biopsyTransbronchial biopsyOpen lung biopsyBronchoalveolar lavageTransbronchial biopsyBronchoalveolar lavage negative, cervical skin biopsy positiveBronchoalveolar lavage and transbronchial biopsyVATS surgical biopsyBronchoalveolar lavage. Central bronchoscopic biopsies. Gastric origin by EGD.Bronchoalveolar lavage showed atypical cells. Transbronchial biopsies could not be done.Bronchoscopy could not be completed. Diagnosed by surgical lung biopsyOpen lung biopsyTransbronchial biopsy, prostate biopsy
DiagnosisAdenocarcinoma unknown primaryRenal adenocarcinomaAdenocarcinoma of colonSignet ring gastric adenocarcinomaMelanomaSignet ring gastric adenocarcinomaSignet ring gastric adenocarcinomaPulmonary adenocarcinomaGastric adenocarcinomaGastric adenocarcinoma with focal signet ring.Signet ring cell gastric adenocarcinoma on EGD biopsyPulmonary adenocarcinomaPulmonary adenocarcinomaProstate adenocarcinoma
Symptom onset to diagnosis (days)107NA180117Over 30 days150180NANA6060NA37942
Symptom to death (days)108NA191119NA159180NANANANANA382NA
Presentation to death (days)70NA1629NANA67NANANANANA17NA
Diagnosis to death (days)1NA1112NA77NANANANANA3NA
Therapy prior to diagnosisPrednisone, clarithromycin, salbutamol, antitubercular, antipneumocystis therapy.NASteroids for sarcoidosis. Folfox after diagnosisCiprofloxacin and erythromycin for bronchitis, right heart Cath, sildenafil, and ambrisentan for Pulm HTN.Vancomycin and piperacillin-tazobactamAntibiotics and steroidsImmunosuppressive therapyNASteroidsBroad-spectrum antibiotics for 14 days, high dose steroidsPiperacillin-tazobactam, ciprofloxacin, and oseltamivirNAAntibiotics.Not applicable. Survived.
Setting of diagnosisICU ventNAPost biopsy, ICU, ventICU. Biopsy while intubated, palliative postdiagnosisNon-ICU settingICU on vent supportNANot in ICUNANANaNAICUNA
MetastasisNot available (NA)NAThoracic and lumbar spineAbdominal wall, tibia, femur, right humerus, lumbar spineNANASkinContralateral pulmonary and spinal metastasis.NALung, pleura, right ribs, right iliac boneNANANANA
AuthorGilchrist et al., Eur Resp Review [5]Vanclaire et al., Arch Fr Pediatrics [6]Thomas and Lenox, CMAJ [7]Khachekian et al., J Am Osteopath Assoc. [8]Biswas et al., Am Journal of Medicine [9]Dikis et al., Clinics in Surgery [10]Wang et al., Poster, chest meeting [11]Guler et al. [12], Journal of clinical respiratory disease & care.Gleason et al., J of clinical and diagnostic research [13]Moubax et al., BMC research notes [14]Meltem et al., Turkish thoracic journal [15]Blanco et al., An Med Interna [16]Mapel et al.,
Lung Cancer [17]
Cohen et al. [18],
Respiration