Lung cancer with lymphangitis carcinomatosis

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Cough with shortness of breath on exertion for a few months.

Patient Data

Age: 60-70 years
Gender: Female

Large right upper lobe mass. Reticular opacity through the right lung. Left lung appears clear. No pleural effusion. Sternotomy wires. 

Two months later

x-ray

Progressive right upper lobe opacity and increased right lung reticulonodular opacity. Left lung is clear. 

Right lower lobe and left upper and lobe pulmonary emboli.

Right upper lobe mass with bronchovascular encasement and mediastinal invasion. Partial right upper lobe collapse with invasion/occlusion of the right upper lobe apical and anterior segmental bronchi. Small right pleural effusion.

Right hilar and mediastinal lymphadenopathy. 

Left lung peripheral ground-glass opacities likely represent small infarcts. 

Large adrenal masses are likely metastases. 

Case Discussion

A complex case of lung cancer with worsening collapse, mediastinal invasion with extensive bronchovascular encasement, and progressing lymphangitis carcinomatosis. Further complicated by numerous pulmonary emboli and likely small lung infarcts

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