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Lymphangitic Carcinomatosis
Sonia L. Betancourt Cuellar, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Lymphangitic carcinomatosis (LC)
            • Synonyms

              • Lymphangitic spread
              • Interlobular interstitium = interlobular septa
                • Thick interlobular interstitium = septal lines = interlobular septal thickening
            • Definitions

              • Tumor infiltration of lymphatic channels from tumor emboli (common) or direct retrograde spread from affected hilar lymph nodes
              • LC results primarily from adenocarcinomas
                • Lung
                • Breast
                • Other: Stomach, colon, pancreas, prostate
              • Involvement of lymphatic channels within interlobular and subpleural interstitium (i.e., peripheral interstitium) &/or central lymphatic channels within bronchovascular and centrilobular interstitium (i.e., axial interstitium)

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Diagnosis

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Charest M et al: Prognostic implication of the lymphangitic carcinomatosis pattern on perfusion lung scan. Can Assoc Radiol J. 63(4):294-303, 2012
                                              2. Prakash P et al: FDG PET/CT in assessment of pulmonary lymphangitic carcinomatosis. AJR Am J Roentgenol. 194(1):231-6, 2010
                                              3. CastaƱer E et al: Diseases affecting the peribronchovascular interstitium: CT findings and pathologic correlation. Curr Probl Diagn Radiol. 34(2):63-75, 2005
                                              4. Digumarthy SR et al: Fluorodeoxyglucose positron emission tomography pattern of pulmonary lymphangitic carcinomatosis. J Comput Assist Tomogr. 29(3):346-9, 2005
                                              5. Johkoh T et al: CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol. 158(6):1217-22, 1992
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Lymphangitic carcinomatosis (LC)
                                                        • Synonyms

                                                          • Lymphangitic spread
                                                          • Interlobular interstitium = interlobular septa
                                                            • Thick interlobular interstitium = septal lines = interlobular septal thickening
                                                        • Definitions

                                                          • Tumor infiltration of lymphatic channels from tumor emboli (common) or direct retrograde spread from affected hilar lymph nodes
                                                          • LC results primarily from adenocarcinomas
                                                            • Lung
                                                            • Breast
                                                            • Other: Stomach, colon, pancreas, prostate
                                                          • Involvement of lymphatic channels within interlobular and subpleural interstitium (i.e., peripheral interstitium) &/or central lymphatic channels within bronchovascular and centrilobular interstitium (i.e., axial interstitium)

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Diagnosis

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Charest M et al: Prognostic implication of the lymphangitic carcinomatosis pattern on perfusion lung scan. Can Assoc Radiol J. 63(4):294-303, 2012
                                                                                          2. Prakash P et al: FDG PET/CT in assessment of pulmonary lymphangitic carcinomatosis. AJR Am J Roentgenol. 194(1):231-6, 2010
                                                                                          3. CastaƱer E et al: Diseases affecting the peribronchovascular interstitium: CT findings and pathologic correlation. Curr Probl Diagn Radiol. 34(2):63-75, 2005
                                                                                          4. Digumarthy SR et al: Fluorodeoxyglucose positron emission tomography pattern of pulmonary lymphangitic carcinomatosis. J Comput Assist Tomogr. 29(3):346-9, 2005
                                                                                          5. Johkoh T et al: CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol. 158(6):1217-22, 1992