Carcinomatous lymphangitis

Definition: Carcinomatous lymphangitis is a radioclinical entity accounting for about 8% of all cases of lung metastasis defined as the presence of tu moral cells in lymph vessels and lung interstitium. Diagnosis: Biopsy specimens or bronchial brushings obtained by fibroendosco py or bronchioalveolar lavage fluid usually reveal adenocarcinoma. Practical management: in clinical practice, the patient presents with dyspn ea and non-specific infiltration on the chest x-ray. The clinical situation worsens rapidly. Millimetric CT-scan shows highly suggestive polygonal ima ges in the subpleural area. Respiratory function tests may be helpful for t he differential diagnosis, particularly in difficult cases, showing a mixed ventilation disorder without altered carbonmonoxide diffusion and hypoxemi a at rest without hypercapnia. Search for the primary cancer: Primary lesions must be identified for speci fic treatment. Pathology findings help guide the search. Despite the highly unfavorable prognosis (median survival = 3 months), etiological treatment when possible can improve quality of life and possibly survival. Symptomati c treatment is indicated and must be adapted to each individual case.