Pulmonary lymphangitic carcinomatosis from gallbladder cancer mimicking diffuse alveolar haemorrhage

Abstract

Diagnosis in cases with pulmonary lymphangitic carcinomatosis as a primary manifestation is difficult due to unawareness of the cancer. An 81‐year‐old man was admitted due to a one‐week history of dyspnoea and haemoptysis. Chest computed tomography showed diffuse bilateral ground‐grass opacity and partial consolidation. We suspected diffuse alveolar haemorrhage. High‐dose methylprednisolone and cyclophosphamide did not improve his condition and he died from respiratory failure. Autopsy revealed pulmonary lymphangitic carcinomatosis of whole lungs and primary gallbladder cancer. We should consider pulmonary lymphangitic carcinomatosis in the differential diagnosis of patients with haemoptysis and diffuse lung opacity of unknown origin.

Pulmonary lymphatic involvement in metastatic uterine sarcomas: imaging and pathological appearance

“…However, ground-glass opacity along the interlobular septa due to tumor extension has not been reported previously for PLS. Although there have been a few case reports describing relative diffuse ground-glass opacity on CT in the patients with PLC, the well-circumscribed and localized ground-glass opacity along the interlobular septa like this case has not been reported previously [5] , [6] , [7] .…”

“…However, these findings were not seen in this case; bronchial pneumonia and post-inflammatory changes were also considered, but the course was atypical. Interstitial pneumonia and infections, including Covid-19 pneumonia, could be the differential diagnoses of diffuse ground-glass opacity; however, these diagnoses were not positively suggested in this case because of the well-circumscribed and localized nature of the ground-glass opacity surrounding the lobule [5] , [6] , [7] , [9] .…”

Postmortem Diagnosis of Gallbladder Cancer Presenting as Pulmonary Lymphangitic Carcinomatosis With Concurrent Gallbladder Adenomyomatosis

“…Moreover, reports of gallbladder cancer presenting with pulmonary lymphangitic carcinomatosis are limited. There are only two case reports of pulmonary lymphangitic carcinomatosis caused by gallbladder cancer [ 7 , 8 ]. We report a case of postmortem diagnosed gallbladder cancer with pulmonary lymphangitic carcinomatosis in a patient who had been followed up for six years for gallbladder adenomyomatosis.…”

Lymphangitis carcinomatosa from gallbladder cancer

“…Primary lesions for lymphangitis carcinomatosa vary and breast cancer, lung cancer and stomach cancer are the main causative primary lesions [ 3 ]. Although lung metastasis has been reported in 34.3% of gallbladder cancer autopsy cases [ 4 ], gallbladder cancer has been reported as a primary tumor for lymphangitis carcinomatosa only in one previous case [ 5 ]. In this case, diffuse alveolar haemorrhage was suspected from computed tomography (CT) findings during his life time, and it was not until pathological autopsy was performed that both lymphangitis carcinomatosa and gallbladder cancer was diagnosed [ 5 ].…”

“…Although lung metastasis has been reported in 34.3% of gallbladder cancer autopsy cases [ 4 ], gallbladder cancer has been reported as a primary tumor for lymphangitis carcinomatosa only in one previous case [ 5 ]. In this case, diffuse alveolar haemorrhage was suspected from computed tomography (CT) findings during his life time, and it was not until pathological autopsy was performed that both lymphangitis carcinomatosa and gallbladder cancer was diagnosed [ 5 ]. Herein, we report the first case of lymphangitis carcinomatosa from gallbladder cancer which we could diagnose during her life time.…”