title: [A case of pulmonary carcinomatous lymphangitis and multiple pulmonary infarctions from gastric cancer].
abstract: We report a case of pulmonary carcinomatous lymphangitis and multiple pulmonary infarctions from gastric cancer. A 58-year-old housewife presented with a complaint of a worsening cough over the previous 6 weeks. Chest radiography and CT scans revealed infiltration and diffuse ground-glass opacities in both lung fields, and she was hospitalized for further examination. No specific findings were found upon screening examination, including bronchoscopy with bronchoalveolar lavage (BAL). However, a CT scan showed mediastinal, hilar and paraaortic lymph node swelling, and therefore we suspected the presence of a malignant tumor. On the 11th hospital day, she suddenly developed severe hypoxia and went into cardiogenic shock. Although there was no sign of a filling defect in the vessels on CT with an intravenous contrast, we diagnosed pulmonary thromboembolism based on other examination findings and began thrombolysis and anticoagulant therapy. Treatment with heparin and urokinase did not improve her condition, and she died on the 14th hospital day. The autopsy findings revealed widespread gastric cancer with pulmonary lymphangitis carcinomatosa and thrombus formation in arterioles throughout the pulmonary lobes: 'Trousseau syndrome'.
authors: Center of Respiratory Diseases, Shinko Hospital.
authors: Yasuko
authors: Y
authors: Koma
authors: Hirofumi
authors: H
authors: Matsuoka
authors: Towa
authors: T
authors: Ryoke
authors: Midori
authors: M
authors: Koyama
authors: Kensuke
authors: K
authors: Fukumitsu
authors: Yoshitaka
authors: Y
authors: Kasai
authors: Daiki
authors: D
authors: Masuya
authors: Harukazu
authors: H
authors: Yoshimatsu
authors: Sohei
authors: S
authors: Kitazawa
authors: Yujiro
authors: Y
authors: Suzuki
mesh_terms: D001344:Autopsy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D008205:Lymphangitis / Q000150:complications*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000473:pathology*; D054060:Pulmonary Infarction / Q000150:complications*; D013274:Stomach Neoplasms / Q000473:pathology*