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Bronchogenic carcinoma with lymphangitic spread

Case contributed by Dr Ahmed Abdrabou


Dyspnea, productive cough and chest pain with previous pulmonary tuberculous infection

Patient Data

Age: 65 years
Gender: Male

CT scout image reveals an ill defined opacity of the right parahilar region. CT images reveal an ill defined, irregular shaped spiculated soft tissue lesion occupying the anterior segment of right upper lobe. There is associated septal thickening, thickening and nodularity of the bronchovascular bundle and lymphadenopathies especially the right hilar, right lower paratracheal and subcarinal groups, some of them show calcification. Mild right pleural effusion is noted.

Diagnosis: Adenocarcinoma in situ of the lung (previously known as bronchogenic adenocarcinoma) (pathology proven) with lymphangitis carcinomatosis.

Annotated image

The red arrows refer to the spicules of the mass which indicate tissue microinvasion

The green arrows refer to the peribronchovascular thickening and nodularity

Case Discussion

Lymphangitic spread in the lung occurs with certain types of tumors including adenocarcinoma in-situ of the lung, breast cancer, lymphoma and GIT malignancies. However, they usually produce bilateral parenchymal lung changes. Adenocarcinoma in situ of the lung can produce unilateral affection.

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Case information

rID: 29002
Published: 26th Apr 2014
Last edited: 11th Feb 2020
System: Chest
Inclusion in quiz mode: Included

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