title: Lymphangitis carcinomatosa as an unusual presentation of renal cell carcinoma: a case report.
abstract: BACKGROUND
  Renal cell carcinoma is a common adult malignancy that can present incidentally or with a multitude of clinical symptoms and signs. Metastatic spread is frequent, occurring via haematogenous and lymphatic routes, although it does not typically present with lymphangitis carcinomatosa.
  
  
  METHODS
  We describe a patient who presented with cough and increasing dyspnoea. Initial chest x-ray and computed tomography were consistent with lymphangitis carcinomatosa that proved secondary to underlying renal cell carcinoma.
  
  
  CONCLUSIONS
  Lymphangitis carcinomatosa occurs with many different primary tumours and can rarely be the presenting feature of renal cell carcinoma. Underlying renal cell carcinoma should be considered in the differential diagnosis of lymphangitis carcinomatosa and excluded with subsequent investigations.
authors.affiliation: Queens Medical Centre, Nottingham, UK. jameskirk@doctors.org.uk
authors.forename: James E
authors.initials: JE
authors.lastname: Kirk
authors.forename: Maruti
authors.initials: M
authors.lastname: Kumaran