Pulmoner lenfanjitik karsinomatozis

Özet

Pulmoner lenfanjitik karsinomatozis, metastatik tümör hücrelerinin akciğer lenfatikleri boyunca yayılmasıyla gelişir ve bilinen kanseri olan ya da henüz primeri saptanmamış hastada ilerleyici dispneyle ortaya çıkabilir. HRCT'de interlobüler septalarda düzgün veya nodüler kalınlaşma ve peribronkovasküler kalınlaşma görülebilir. Plevral efüzyon ve mediastinal lenfadenopati eşlik edebilir; ancak pulmoner nodül, kitle veya mediastinal lenfadenopati olmaması PLC’yi dışlamaz. Özellikle enfeksiyon veya interstisyel akciğer hastalığı sanılabilen PLC’nin tanısındaki gecikme, altta yatan malignitenin tanınmasını geciktirebilir ve solunum durumunun hızla kötüleşmesine eşlik edebilir.

Faz ve pencere

HRCT tanısal

İnce kesit akciğer görüntüleri interlobüler septa, peribronkovasküler kılıflar, fissürler ve subplevral interstisyumdaki düzensiz ya da nodüler kalınlaşmayı gösterir; parankimal dağılım örüntüsü için kontrast gerekmez.

Önerilen pencereler: Akciğer (G 1500 / M -600), Mediasten (G 350 / M 50).

BT bulguları

• Nodüler septal kalınlaşma — sekonder pulmoner lobül kenarlarını oluşturan septalar boncuklu veya düzensiz çizgiler şeklinde kalınlaşır.
• Düzgün septal kalınlaşma — lenfatik yayılım bazı hastalarda nodüler değil, ince ve düzgün septal çizgiler olarak izlenebilir.
• Peribronkovasküler kalınlaşma — bronş ve eşlik eden pulmoner arter dalları boyunca uzanan interstisyel kılıflar belirginleşir.
• Lenfanjitik yayılımın BT bulgularında interlobüler septalarda nodüler kalınlaşma sıkça izlenir.
• İnterlobüler septalarda nodüler veya düzgün kalınlaşma görülebilir; bu bulgu pulmoner ödem gibi diğer durumlarda da izlenebilir.
• Asimetrik veya tek taraflı tutulum — hastalık iki taraflı olabilse de bir hemitoraksta ya da belirli loblarda belirgin baskınlık gösterebilir.
• Buzlu cam veya ince retikülasyon — interstisyel yayılıma alveoler opasite eklenebilir; tek başına bu alanlar özgül değildir.
• Eşlik eden plevral ve nodal bulgular — plevral efüzyon/kalınlaşma ve hiler-mediastinal lenfadenopati görülebilir.

Ayırıcı tanı

Kardiyojenik interstisyel ödem

genellikle iki taraflı ve simetrik düzgün septal kalınlaşma, merkezi buzlu cam, kardiyomegali ve plevral sıvıyla birliktedir; nodüler septal kenar daha az beklenir.

Sarkoidoz

üst ve orta loblarda perilenfatik mikronodüller ile simetrik hiler lenfadenopati tipiktir; bilinen tümör veya tek taraflı baskın septal yayılımı açıklamayabilir.

Lenfoma

peribronkovasküler veya septal yumuşak doku kalınlaşması yapabilir; eşlik eden kitle, lenf düğümü ve klinik lenfoproliferatif hastalık bulguları araştırılır.

Enfeksiyöz bronşiolit

sentrilobüler tomurcuklu dal nodülleri ve bronşiol merkezli dağılım gösterir; septaları ve fissürleri kesintisiz izleyen kalınlaşma beklenmez.

Pulmoner venöz hipertansiyon

düzgün septal çizgiler ve plevral sıvı oluşturabilir; kalp büyümesi ve merkezi damar dolgunluğu eşlik eder, nodüler septal görünüm tipik değildir.

Tuzaklar

• Her septal kalınlaşma lenfanjitik yayılım anlamına gelmez; pulmoner ödem de düzgün interlobüler septal kalınlaşma yapabilir, bu nedenle görünüm ve dağılım eşlik eden bulgularla birlikte değerlendirilmelidir.
• Lenfanjitik karsinomatozis yalnızca nodüler septalarla ortaya çıkmaz; düzgün septal ve peribronkovasküler kalınlaşma da özellikle asimetrik dağılımda kuşku uyandırabilir.
• Dominant bulguların yanlış tanımlanması veya önceki görüntülerle karşılaştırılmaması yanlış pozitiflere yol açabilir; ayrıca farklı interstisyel hastalıkların benzer görünüm gösterdiği unutulmamalıdır.
• Bilinen primer tümör yokluğu lenfanjitik yayılımı dışlamaz; akciğer bulguları okült malignitenin ilk işareti olabilir.

Kendini dene

1. Pulmoner lenfanjitik karsinomatozisli 35 hastanın incelendiği çalışmada başlıca BT bulgusu neydi?

   • Nodüler septal kalınlaşma
   • İzole hava hapsi
   • Santral lobüler amfizem
   • Düzgün plevral plaklar
   Cevabı göster

   Nodüler septal kalınlaşma. Çalışmada 35 hastanın 30'unda nodüler septal kalınlaşma, pulmoner lenfanjitik karsinomatozisin başlıca BT bulgusu olarak bildirilmiştir.

2. Nodüler interlobüler septal kalınlaşma hangi durumda görülebilir?

   • Lenfanjitik tümör yayılımı
   • Pulmoner emboli
   • Amfizem
   • Plevral plak
   Cevabı göster

   Lenfanjitik tümör yayılımı. Nodüler interlobüler septal kalınlaşma lenfanjitik tümör yayılımında görülebilir; kaynakta sarkoidoz ve silikoz da olası nedenler arasında sayılmıştır.

İlgili konular

• Pulmoner amiloidoz
• Pulmoner sarkoidoz
• Normal görünüm ve ince septal çizgiler

Kaynaklar

Bu sayfadaki 31 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 12 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Prognostic value of pretherapeutic FDG PET/CT in non-small cell lung cancer with pulmonary lymphangitic carcinomatosispmc.ncbi.nlm.nih.gov
2. Pulmonary lymphangitic carcinomatosis as a primary manifestation of gastric carcinoma in a young adult: a case report and review of the literature.pubmed.ncbi.nlm.nih.gov
3. The Role of [18F]FDG PET Imaging for the Assessment of Pulmonary Lymphangitic Carcinomatosis: A Comprehensive Narrative Literature Review.pubmed.ncbi.nlm.nih.gov
4. Metastatic colorectal micropapillary carcinoma presenting as lymphangitic lung carcinomatosis.pubmed.ncbi.nlm.nih.gov
5. Pulmonary lymphangitic carcinomatosis secondary to ureteral cancer.pubmed.ncbi.nlm.nih.gov
6. Acantholytic squamous cell carcinoma of the lung with marked lymphogenous metastases and high titers of myeloperoxidase-antineutrophil cytoplasmic antibodies: a case report.pubmed.ncbi.nlm.nih.gov
7. Pulmonary lymphangitic carcinomatosis from head and neck squamous cell carcinoma.pubmed.ncbi.nlm.nih.gov
8. Pulmonary lymphangitic carcinomatosis in liver carcinoma: a rare case report and literature review.pubmed.ncbi.nlm.nih.gov
9. Prognosis of pulmonary lymphangitic carcinomatosis in patients with non-small cell lung cancer.pubmed.ncbi.nlm.nih.gov
10. FDG PET/CT in assessment of pulmonary lymphangitic carcinomatosis.pubmed.ncbi.nlm.nih.gov
11. Pulmonary lymphangitic carcinomatosis from metastatic gastric adenocarcinoma: case report.pubmed.ncbi.nlm.nih.gov
12. Clinical outcome of pulmonary lymphangitic carcinomatosis in gynecologic malignancy: A single-institution experience.pubmed.ncbi.nlm.nih.gov
13. Pulmonary lymphangitic carcinomatosis from gallbladder cancer mimicking diffuse alveolar haemorrhage.pubmed.ncbi.nlm.nih.gov
14. 18F-PSMA-1007 Uptake in Pulmonary Lymphangitic Carcinomatosis Metastasis From Prostate Cancer.pubmed.ncbi.nlm.nih.gov
15. Fulminant Pulmonary Hypertension Due to Pulmonary Lymphangitic Carcinomatosis and Tumor Embolism From Occult Pulmonary Adenocarcinoma.pubmed.ncbi.nlm.nih.gov
16. Advanced cystic lung cancer complicated with pulmonary lymphangitic carcinomatosis: a case report.pubmed.ncbi.nlm.nih.gov
17. Endobronchial Metastasis as the Dominant Pulmonary Manifestation of Sigmoid Colon Adenocarcinoma: A Case Report.pubmed.ncbi.nlm.nih.gov
18. Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist's Key Role.pubmed.ncbi.nlm.nih.gov
19. Consensus statement on thoracic radiology terminology in Portuguese used in Brazil and in Portugal.pubmed.ncbi.nlm.nih.gov
20. Diffuse smoking-related lung diseases: insights from a radiologic-pathologic correlation.pubmed.ncbi.nlm.nih.gov
21. New insights into imaging of pulmonary metastases from extra-thoracic neoplasms.pubmed.ncbi.nlm.nih.gov
22. Fleischner Society: Glossary of Terms for Thoracic Imaging.pubmed.ncbi.nlm.nih.gov
23. Primary malignant epithelioid hemangioendothelioma of the pleura: A review and report of a novel case.pubmed.ncbi.nlm.nih.gov
24. Non-thrombotic pulmonary emboli: imaging findings and differential diagnoses.pubmed.ncbi.nlm.nih.gov
25. Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation.pubmed.ncbi.nlm.nih.gov
26. Lung imaging methods: indications, strengths and limitations.pubmed.ncbi.nlm.nih.gov
27. Clinicopathological Outlines of Post-COVID-19 Pulmonary Fibrosis Compared with Idiopathic Pulmonary Fibrosis.pubmed.ncbi.nlm.nih.gov
28. High-resolution computerized tomography changes in diffuse parenchymal lung disease from chronic hypersensitivity pneumonitis related to bird antigen.pubmed.ncbi.nlm.nih.gov
29. Isolated pulmonary lymphangitic carcinomatosis as the initial manifestation of renal cell carcinoma.pubmed.ncbi.nlm.nih.gov
30. Pulmonary lymphangitic carcinomatosis as an unusual presentation of renal cell carcinoma: a case report and a brief literature review.pubmed.ncbi.nlm.nih.gov
31. Gastric mucinous adenocarcinoma presenting with chronic cough, bronchovascular bundle thickening, and multiple pulmonary nodules: a case report.pubmed.ncbi.nlm.nih.gov
32. Perilymphatic micronodular pattern as a manifestation of pulmonary amyloidosis on high-resolution computed tomography.pubmed.ncbi.nlm.nih.gov
33. Spectrum of high-resolution computed tomography imaging in occupational lung disease.pubmed.ncbi.nlm.nih.gov
34. The crazy-paving pattern: a radiological-pathological correlation.pubmed.ncbi.nlm.nih.gov
35. A case report of unexpected rapid regression of diffuse pulmonary lymphangiomatosis mimicking advanced lung cancer.pubmed.ncbi.nlm.nih.gov
36. Uncommon Causes of Interlobular Septal Thickening on CT Images and Their Distinguishing Features.pubmed.ncbi.nlm.nih.gov
37. The role of vascularity and the fibrovascular interface in interstitial lung diseases.pubmed.ncbi.nlm.nih.gov
38. CT findings of lung injury during breast cancer treatment.pubmed.ncbi.nlm.nih.gov
39. Drug-Induced Interstitial Lung Disease in Lung Cancer Patients.pubmed.ncbi.nlm.nih.gov
40. Symptomatic diffuse pulmonary meningotheliomatosis with persistent diffusing-capacity impairment.pubmed.ncbi.nlm.nih.gov
41. Noninfectious Granulomatous Lung Disease: Radiological Findings and Differential Diagnosis.pubmed.ncbi.nlm.nih.gov
42. CT Findings in Pulmonary and Abdominal Sarcoidosis. Implications for Diagnosis and Classification.pubmed.ncbi.nlm.nih.gov
43. Pulmonary Complications of Cancer Therapy: Clinical Presentations, Imaging Patterns, and Management Strategies.pubmed.ncbi.nlm.nih.gov
44. Pulmonary Tumor Embolism and Pulmonary Tumor Thrombotic Microangiopathy Causing Rapidly Progressive Respiratory Failure: A Case Series.pubmed.ncbi.nlm.nih.gov
45. Tumoral pulmonary hypertension.pubmed.ncbi.nlm.nih.gov
46. Mimics in chest disease: interstitial opacities.pubmed.ncbi.nlm.nih.gov
47. Lymphocyte dynamics as the central mediator in osimertinib-induced CD4 + T-cell depletion, fulminant cytomegalovirus pneumonitis, and progressive pulmonary fibrosis: a case report.pubmed.ncbi.nlm.nih.gov
48. Metastatic malignant melanoma presenting as bilateral acute mastitis in a lactating woman: a case report and literature review.pubmed.ncbi.nlm.nih.gov
49. Lung Manifestations of Metastatic Duodenal Adenocarcinoma: A Case Report.pubmed.ncbi.nlm.nih.gov
50. Pulmonary lymphangitic carcinomatosis mimicking interstitial lung disease.pubmed.ncbi.nlm.nih.gov
51. Differential diagnosis of pulmonary sarcoidosis: a review.pubmed.ncbi.nlm.nih.gov
52. Imaging More than Skin-Deep: Radiologic and Dermatologic Presentations of Systemic Disorders.pubmed.ncbi.nlm.nih.gov
53. Acute Hypoxic Respiratory Failure in Advanced Hepatocellular Carcinoma Secondary to Diffuse Pulmonary Metastases and Malignancy-Associated Hypercoagulability: A Case Report.pubmed.ncbi.nlm.nih.gov
54. Pulmonary Arterial Hypertension Due to Talc Granulomatosis Following Intravenous Use of Oral Medications: A Report of a Rare Case.pubmed.ncbi.nlm.nih.gov
55. Osteosarcoma Metastasis to the Thorax: A Pictorial Review of Chest Computed Tomography Findings.pubmed.ncbi.nlm.nih.gov
56. Pitfalls in diagnosis of infiltrative lung disease by CT.pubmed.ncbi.nlm.nih.gov
57. Niemann-Pick disease type B: HRCT assessment of pulmonary involvement.pubmed.ncbi.nlm.nih.gov
58. The intersection of liver cirrhosis and pulmonary fibrosis.pubmed.ncbi.nlm.nih.gov
59. Pulmonary Veno-Occlusive Disease: A Focused Clinicopathologic Series.pubmed.ncbi.nlm.nih.gov
60. Atypical Fibrotic-Mimicking Pulmonary Sarcoidosis in a Young Female: The Basal Conundrum.pubmed.ncbi.nlm.nih.gov
61. Systemic Sarcoidosis With Neurosarcoidosis and Obstructive Hydrocephalus: A Radiologic-Pathologic Case Report.pubmed.ncbi.nlm.nih.gov
62. Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats.pubmed.ncbi.nlm.nih.gov
63. CT Findings of Central Airway Lesions Causing Airway Stenosis-Visualization and Quantification: A Pictorial Essay.pubmed.ncbi.nlm.nih.gov
64. Diagnosis and Treatment of Hypersensitivity Pneumonitis: S2k Guideline of the German Respiratory Society and the German Society for Allergology and Clinical Immunology.pubmed.ncbi.nlm.nih.gov
65. Assessing Venous Congestion in Acute and Chronic Heart Failure: A Review of Splanchnic, Cardiac and Pulmonary Ultrasound: Part 1: Conventional B-Mode, Colordoppler, and Vexus Protocol.pubmed.ncbi.nlm.nih.gov
66. A systematic approach to interpretation of heterogeneous lung attenuation on computed tomography of the chest.pubmed.ncbi.nlm.nih.gov
67. Lipoid Pneumonia: HRCT and MRI Spectrum, Diagnostic Pitfalls, and Imaging-Based Diagnostic Workflow.pubmed.ncbi.nlm.nih.gov
68. Diffuse cystic lung diseases-a primer for radiologists.pubmed.ncbi.nlm.nih.gov
69. Immune Checkpoint Inhibitor-Related Pneumonitis in Renal Cell Carcinoma: Clinical Features, Mechanisms, and Lessons from Lung Cancer.pubmed.ncbi.nlm.nih.gov
70. Vascular endothelial growth factor-C induces lymphangitic carcinomatosis, an extremely aggressive form of lung metastases.pubmed.ncbi.nlm.nih.gov
71. Fulminant Multisystem IgA Vasculitis With Diffuse Alveolar Hemorrhage, Severe Gastrointestinal Hemorrhage, Paralytic Ileus, and Renal Involvement in an Adolescent: A Case Report.pubmed.ncbi.nlm.nih.gov
72. The Impact of Genetics on Pediatric Interstitial Lung Diseases: A Narrative Literature Review and Clinical Implications.pubmed.ncbi.nlm.nih.gov
73. Medication-induced lung disease in children.pubmed.ncbi.nlm.nih.gov
74. Histopathologic Findings in Three Dogs With Metastatic Carcinoma Presenting With Bronchovascular Bundle Thickening on Computed Tomography.pubmed.ncbi.nlm.nih.gov
75. Pulmonary Lymphangitic Carcinomatosis: An Atypical Presentation Leading to Discovery of Multi-Organ Metastasis With Unknown Occult Primary Malignancy.pubmed.ncbi.nlm.nih.gov
76. Diagnosis and management of patients with stage III non‑small cell lung cancer: A joint statement by the Lebanese Society of Medical Oncology and the Lebanese Pulmonary Society (Review).pubmed.ncbi.nlm.nih.gov
77. Clinical benefit of paclitaxel/carboplatin plus bevacizumab with zoledronic acid in pulmonary epithelioid hemangioendothelioma complicated by hypertrophic pulmonary osteoarthropathy and cardiac tamponade: a case report.pubmed.ncbi.nlm.nih.gov
78. Complete remission following targeted therapy in BRAF V600E: mutant pulmonary lymphangitic carcinomatosis secondary to rectal cancer-a case report.pubmed.ncbi.nlm.nih.gov
79. Pneumonitis Associated with Immune Checkpoint Inhibitors and Targeted Anticancer Therapies: A Retrospective Case Series of 12 Patients.pubmed.ncbi.nlm.nih.gov
80. Metastatic Breast Cancer Presenting as an Organizing Pneumonia Pattern on Chest CT: A Case Report.pubmed.ncbi.nlm.nih.gov
81. Retrospective Review Is the Best View: A Primer for Residents and Radiologists on Missed Findings in Chest Radiography.pubmed.ncbi.nlm.nih.gov
82. Evolving landscape of imaging-based evaluation in systemic autoimmune rheumatic disease-associated interstitial lung disease: from visual assessment to quantitative artificial intelligence-assisted evaluation.pubmed.ncbi.nlm.nih.gov
83. Advances in diagnosis of lung fibrosis: focus on present and future approaches.pubmed.ncbi.nlm.nih.gov
84. Lung parenchymal and cardiac appearances on computed tomography pulmonary angiography impact survival in chronic thromboembolic pulmonary hypertension: results from the ASPIRE Registry.pubmed.ncbi.nlm.nih.gov
85. Comprehensive radiologic-pathologic correlation in systemic sclerosis-associated interstitial lung disease: identification of an early-stage CT findings.pubmed.ncbi.nlm.nih.gov
86. Imaging of Childhood Interstitial Lung Disease.pubmed.ncbi.nlm.nih.gov
87. Multimodality Imaging for the Diagnosis and Evaluation of Pulmonary Sarcoidosis.pubmed.ncbi.nlm.nih.gov
88. Interstitial Lung Disease and Cardiotoxicity Associated with Trastuzumab Deruxtecan, Sacituzumab Govitecan, and Trastuzumab Emtansine: A Narrative Review.pubmed.ncbi.nlm.nih.gov
89. Interstitial lung diseases-can pathologists arrive at an etiology-based diagnosis? A critical update.pubmed.ncbi.nlm.nih.gov
90. Interstitial lung diseases in children.pubmed.ncbi.nlm.nih.gov
91. Primary Lymphoproliferative Lung Diseases: Imaging and Multidisciplinary Approach.pubmed.ncbi.nlm.nih.gov
92. AWMF S2k Guideline: Diagnosis and Assessment of Lung Disease Caused by Occupational Silica Dust Exposure (Silicosis) - Disease No. 4101 as per Occupational Diseases Ordinance (BKV) Annex 1.pubmed.ncbi.nlm.nih.gov
93. COVID-19 Pneumonia and Lung Cancer: A Challenge for the RadiologistReview of the Main Radiological Features, Differential Diagnosis and Overlapping Pathologies.pubmed.ncbi.nlm.nih.gov
94. CT Characteristics of Non-Small Cell Lung Cancer With Anaplastic Lymphoma Kinase Rearrangement: A Systematic Review and Meta-Analysis.pubmed.ncbi.nlm.nih.gov
95. Approach to Peribronchovascular Disease on CT.pubmed.ncbi.nlm.nih.gov
96. An Unusual First Presentation of Colon Cancer: Pulmonary Lymphangitic Carcinomatosis.pubmed.ncbi.nlm.nih.gov
97. Aging-Related Findings of the Respiratory System in Chest Imaging: Pearls and Pitfalls.pubmed.ncbi.nlm.nih.gov
98. Pathologic and Radiologic Correlation of Adult Cystic Lung Disease: A Comprehensive Review.pubmed.ncbi.nlm.nih.gov
99. Coexistence of Autoantibodies against the Golgi Complex and Ro52 Antigen in a Patient with Nonspecific Interstitial Pneumonia.pubmed.ncbi.nlm.nih.gov
100. Imaging in Diagnosis of Systemic Sclerosis.pubmed.ncbi.nlm.nih.gov
101. Pulmonary Veno-Occlusive Disease: A Clue to Underlying Lymphoma.pubmed.ncbi.nlm.nih.gov
102. An overview on multimodal imaging for the diagnostic workup of pleural mesothelioma.pubmed.ncbi.nlm.nih.gov
103. Pulmonary Manifestations in Patients With Hematologic Malignancies: In Pursuit of an Accurate Diagnosis.pubmed.ncbi.nlm.nih.gov
104. SPOT THE BOT: A comparative quality assessment of AI-generated written instructions for lung ultrasound training.pubmed.ncbi.nlm.nih.gov
105. Unveiling Hidden Variations in Lung Fissures: A Cadaveric Perspective on Surgical and Diagnostic Challenges.pubmed.ncbi.nlm.nih.gov
106. Wiedemann-Steiner Syndrome (WSS): A Neonatal Case Report Expanding the Phenotypic Spectrum of a Previously Reported Missense Variant.pubmed.ncbi.nlm.nih.gov
107. The diagnostic value of CT-guided percutaneous lung biopsy in atypical pulmonary hamartoma and pulmonary sclerosing pneumocytoma.pubmed.ncbi.nlm.nih.gov
108. Hantavirus infection in emergency radiology: Imaging manifestations, pathophysiology, and infection control considerations.pubmed.ncbi.nlm.nih.gov
109. Tissue-retained needles in people who inject drugs: A systematic review of case reports and series on clinical presentations, complications and management.pubmed.ncbi.nlm.nih.gov
110. Ultra-high-resolution synchrotron phase-contrast CT enables microstructural pulmonary imaging at clinical dose levels.pubmed.ncbi.nlm.nih.gov
111. Optimizing transducer choice for the detection of alveolar-interstitial syndrome in dogs and cats: an evidence-based review.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.