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Congress: ECR25
Poster Number: C-15230
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-15230
Authorblock: M. Oaida; Cluj Napoca/RO
Disclosures:
Mara Oaida: Nothing to disclose
Keywords: Lung, Oncology, Respiratory system, Conventional radiography, CT, CT-High Resolution, Computer Applications-Detection, diagnosis, Cancer
Learning objectives The purpose of this article is to provide a thorough analysis of lymphangitic carcinomatosis (LC), focusing on its pathophysiological mechanisms, characteristic imaging findings and differential diagnosis. This presentation aims to enhance diagnostic accuracy and deepen the understanding of LC among healthcare professionals, thereby improving patient management and outcomes. Emphasis is placed on the integration of advanced imaging modalities and clinical correlations to optimize the detection and characterization of LC.
Read more Background Lymphangitic carcinomatosis is a rare and severe manifestation of metastatic disease, most commonly associated with adenocarcinoma of the lung, breast and stomach.(1) The proliferation of malignant cells within the lymphatic system leads to widespread infiltration and subsequent thickening of the interlobular septa, causing significant respiratory impairment.(2)Patients diagnosed with lymphangitic carcinomatosis often exhibit a range of non-specific respiratory symptoms. Among the most common symptoms is dyspnoea which can rapidly escalate in severity. Individuals may also experience a persistent cough that does...
Read more Findings and procedure details Physiopathology Lymphangitic carcinomatosis represents the metastatic spread of the tumour thorough the pulmonary lymphatics. This may happen through a direct lymphatic dissemination from the mediastinal and hilar lymphatic nodes or, more frequently, from primarily hematogenous dissemination followed by lymphatic invasion. This process results in lymphatic obstruction, interstitial oedema, and subsequent structural changes, generating progressive respiratory symptoms.(4)Imaging FindingsThe radiographic manifestations of lymphangitic carcinomatosis can be categorized based on involvement of the peripheric interlobular septa and/or central lymphatic systems (Figure 1). The disease...
Read more Conclusion Lymphangitic carcinomatosis remains a challenging diagnosis due to its non-specific clinical presentation and overlap with other pulmonary conditions. HRCT is invaluable in identifying the subtle yet characteristic imaging features of LC, including interlobular septal thickening, nodularity, and bronchovascular bundle changes. Early recognition through imaging enables timely diagnosis, allowing for targeted therapeutic interventions that can significantly improve patient outcomes.This poster emphasizes the critical role of imaging in the diagnosis of LC and highlights the importance of a multidisciplinary approach that integrates...
Read more References Klimek M. Pulmonary lymphangitis carcinomatosis: systematic review and meta-analysis of case reports, 1970-2018. Postgrad Med [Internet]. 2019 Jul 4 [cited 2025 Jan 3];131(5):309–18. Available from: https://pubmed.ncbi.nlm.nih.gov/30900501/ AK AK, Mantri SN. Lymphangitic Carcinomatosis. Pearls and Pitfalls in Thoracic Imaging: Variants and Other Difficult Diagnoses [Internet]. 2023 Jul 4 [cited 2025 Jan 3];9780521119078:194–5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560921/ Stein MG, Mayo J, Müller N, Aberle DR, Webb WR, Gamsu G. Pulmonary lymphangitic spread of carcinoma: appearance on CT scans. https://doi.org/101148/radiology16223797649 [Internet]. 1987 Feb 1 [cited 2025...
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