Diffuse interlobular septal thickening with some areas of nodularity and irregularity. Subpleural nodularity and thickening of the major fissures. Peribronchovascular distribution of interstitial thickening in the lower lobes bilaterally with patchy consolidation in the basal segments.
There are mixed sclerotic and lytic lesion in the thoracic vertebrae and sternum.
Case Discussion
This patient presented with dyspnea and pleuritic chest pain. She underwent a CTPA which revealed the above findings of lymphangitis carcinomatosis and multiple metastases, first presentation.
A CT of the abdomen and pelvis demonstrated para-aortic lymphadenopathy and further osseous metastases, although no primary malignancy. A PET-CT was also performed, although no primary lesion was identified.
Lymph node biopsy demonstrated metastatic adenocarcinoma. The presumed origin was upper gastrointestinal tract, favored to be gastric carcinoma.
The patient rapidly deteriorated and died shortly after this admission.
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