Severe Pulmonary Hypertension as a Presentation of Carcinomatous Lymphangitis: A Case Report

Carcinomatous lymphangitis is a radioclinical entity defined as the presence of tumor cells in lymph vessels and interstitium of lung. In clinical practice, the patient generally presents with pulmonary dysfunction. We describe a case of documented carcinomatous lymphangitis presented with severe pulmonary hypertension and right-side heart failure. A 34 year-old male went to our emergency room due to sudden onset of severe left chest pain along with dry cough and exertional dyspnea on April 11, 2002. Because of near-fainting and high level of D-dimer, he was admitted to our cardiovascular ward for further evaluation and management. Despite a dedicated effort, the progression of the disease quite rapid and he expired 4 days later. Autopsy revealed carcinomatous lymphangitis with diffuse thrombotic microangiopathy over bilateral lung. In clinical practice, carcinomatous lymphangitis usually presents as a previous malignant metastasis to lymph vessels and lung interstitium; it is rarely presented as pulmonary hypertension and right-side heart failure in the literature. For the differential diagnosis of pulmonary hypertension, “carcinomatous lymphangitis” must be included as a possible cause.

並列關鍵字

carcinomatous lymphangitis ； pulmonary hypertension ； right-side heart failure ； chest pain

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