A Case of Initial Onset of Pulmonary Lymphangitis Carcinomatosa Caused by Ascending Colon Cancer

DOI 6 References
  • Matsuo Kiyoshi
    Department of Respiratory Medicine, National Hospital Organization, Okayama Medical Center
  • Rai Kammei
    Department of Respiratory Medicine, National Hospital Organization, Okayama Medical Center
  • Fujiwara Keiichi
    Department of Respiratory Medicine, National Hospital Organization, Okayama Medical Center
  • Yonei Toshiro
    Department of Respiratory Medicine, National Hospital Organization, Okayama Medical Center
  • Sato Toshio
    Department of Respiratory Medicine, National Hospital Organization, Okayama Medical Center

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  • 肺の癌性リンパ管症を初発症状として発症した結腸癌の1例

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Background. There are much gastric cancer, breast cancer and lung cancer for a primary tumor of the pulmonary lymphangitis carcinomatosa, and it is rare that colon cancer becomes a primary tumor. We report a case of initial onset of pulmonary lymphangitis carcinomatosa caused by ascending colon cancer. Case. A 63-year-old man had complaints of severe cough and dyspnea 2 months ago, therefore he was transferred to our hospital for further examinations and therapy. Chest roentgenogram showed a diffuse interstitial shadow and chest CT scan revealed markedly thickened bronchovascular bundles and alveolar septa, while abdominal CT showed no abnormal findings. We doubted lymphangitis carcinomatosa and searched a primary tumor. Colonoscopic findings showed ascending colon cancer (type-II) with lymphatic vessel infiltration of moderately differentiated adenocarcinoma by immunohistological examination. Under bronchoscopy, immunocytological findings of the bronchoalveolar lavage fluid showed a cluster of adenocarcinoma cells staining cytokeratin (CK) 7 negative, and CK20 positive. We diagnosed pulmonary lymphangitis carcinomatosa caused by ascending colon cancer. He was treated with combination chemotherapy but died due to respiratory failure 48 days from his first medical examination. Conclusion. This was a rare case of initial onset of pulmonary lymphangitis carcinomatosa caused by colon cancer, and was able to be diagnosed immunohistologically.

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