Pulmonary lymphangitic carcinomatosis from gastric signet ring cell carcinoma: three cases report and literature review_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LIU Yin ¹ , CHEN Liang ² , CHEN Lulu ¹ , ZHANG Yingwei ¹ , ZHAO Qi ¹ , DING Jingjing ¹ , HUANG Mei ¹ ,  CAI Hourong ¹

1. Department of Respiratory Medicine, The Affiliated Drum Tower Hospital of Medical School of Nanjing University, Nanjing, Jiangsu 210008, P.R.China;
2. Department of Respiratory Medicine, Jianshi Country Hospital of Traditional Chinese Medicine, Jianshi, Hubei 445300, P.R.China;

Corresponding author：

CAI Hourong, Email: caihourong2013@163.com

Keywords：

Pulmonary lymphangitic carcinomatosis; Gastric signet ring cell carcinoma; Metastasis

DOI：

10.7507/1671-6205.201612041

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ObjectiveTo investigate the clinical, radiological and pathological features of pulmonary lymphangitic carcinomatosis (PLC) from gastric signet ring cell carcinoma.MethodsThe data of 3 cases of PLC from gastric signet ring cell carcinoma were analyzed and relevant literature was reviewed. The electronic databases of Wanfang, VIP, CNKI and PubMed were searched by using the keywords " pulmonary lymphangitic carcinomatosis” and " gastric signet ring cell carcinoma”.ResultsThe average age of three patients was 34 years (ranging from 20 to 50 years). There were 2 males and 1 female. The three patients presented with non-specific respiratory complaints of cough and shortness of breath. Thickening of interlobular septa was the major radiographical abnormality. Mediastinal lymphadenopathy was seen in 1 patient. Bilateral pleural effusion was seen in 2 patients. However, gastroscopy revealed metastatic gastric signet ring cell carcinoma with the presence of lymphagitic carcinomatosis. One patient survived more than seven months with systemic chemotherapy began on day 7 of hospitalization based on the follow-up information available. Literature review found 2 cases of PLC from gastric signet ring cell carcinoma. Two cases were female aged 45 and 59 years. The chief complaints were dry cough and shortness of breath. The survival time was less than 1 month from diagnosis.ConclusionsPLC from gastric signet ring cell carcinoma is easily misdiagnosed as primary pulmonary diseases. Early identification, diagnosis and treatment are crucial to improve the survival of PLC patients.

Citation： LIU Yin, CHEN Liang, CHEN Lulu, ZHANG Yingwei, ZHAO Qi, DING Jingjing, HUANG Mei, CAI Hourong. Pulmonary lymphangitic carcinomatosis from gastric signet ring cell carcinoma: three cases report and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(4): 341-344. doi: 10.7507/1671-6205.201612041 Copy

1.	Bruce DM, Heys SD, Eremin O. Lymphangitis carcinomatosa: a literature review. J R Coll Surg Edinb, 1996, 41(1): 7-13.
2.	Lin WR, Lai RS. Pulmonary lymphangitic carcinomatosis. QJM, 2014, 107(11): 935-936.
3.	Khachekian A, Shargh S, Arabian S. Pulmonary lymphangitic carcinomatosis from metastatic gastric adenocarcinoma: case report. J Am Osteopath Assoc, 2015, 115(5): 332-337.
4.	张英为, 丁晶晶, 陈露露, 等. 24 例肺淋巴管癌病临床分析并文献回顾.中国呼吸与危重监护杂志, 2011, 10(6): 598-599.
5.	Pernot S, Voron T, Perkins G, et al. Signet-ring cell carcinoma of the stomach: impact on prognosis and specific therapeutic challenge. World J Gastroenterol, 2015, 21(40): 11428-11438.
6.	Lee SH, Jee SR, Kim JH, et al. Intramucosal gastric cancer: the rate of lymph node metastasis in signet ring cell carcinoma is as low as that in well-differentiated adenocarcinoma. Eur J Gastroenterol Hepatol, 2015, 27(2): 170-174.
7.	Charest M, Armanious S. Prognostic implication of the lymphangitic carcinomatosis pattern on perfusion lung scan. Can Assoc Radiol J, 2012, 63(4): 294-303.
8.	Ikezoe J, Godwin JD, Hunt KJ, et al. Pulmonary lymphangitic carcinomatosis: chronicity of radiographic findings in long-term survivors. Am J Roentgenol, 1995, 165(1): 49-52.
9.	Prakash P, Kalra MK, Sharma A, et al. FDG PET/CT in assessment of pulmonary lymphangitic carcinomatosis. Am J Roentgenol, 2010, 194(1): 231-236.
10.	Piessen G, Messager M, Leteurtre E, et al. Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg, 2009, 250(6): 878-887.

1. Bruce DM, Heys SD, Eremin O. Lymphangitis carcinomatosa: a literature review. J R Coll Surg Edinb, 1996, 41(1): 7-13.
2. Lin WR, Lai RS. Pulmonary lymphangitic carcinomatosis. QJM, 2014, 107(11): 935-936.
3. Khachekian A, Shargh S, Arabian S. Pulmonary lymphangitic carcinomatosis from metastatic gastric adenocarcinoma: case report. J Am Osteopath Assoc, 2015, 115(5): 332-337.
4. 张英为, 丁晶晶, 陈露露, 等. 24 例肺淋巴管癌病临床分析并文献回顾.中国呼吸与危重监护杂志, 2011, 10(6): 598-599.
5. Pernot S, Voron T, Perkins G, et al. Signet-ring cell carcinoma of the stomach: impact on prognosis and specific therapeutic challenge. World J Gastroenterol, 2015, 21(40): 11428-11438.
6. Lee SH, Jee SR, Kim JH, et al. Intramucosal gastric cancer: the rate of lymph node metastasis in signet ring cell carcinoma is as low as that in well-differentiated adenocarcinoma. Eur J Gastroenterol Hepatol, 2015, 27(2): 170-174.
7. Charest M, Armanious S. Prognostic implication of the lymphangitic carcinomatosis pattern on perfusion lung scan. Can Assoc Radiol J, 2012, 63(4): 294-303.
8. Ikezoe J, Godwin JD, Hunt KJ, et al. Pulmonary lymphangitic carcinomatosis: chronicity of radiographic findings in long-term survivors. Am J Roentgenol, 1995, 165(1): 49-52.
9. Prakash P, Kalra MK, Sharma A, et al. FDG PET/CT in assessment of pulmonary lymphangitic carcinomatosis. Am J Roentgenol, 2010, 194(1): 231-236.
10. Piessen G, Messager M, Leteurtre E, et al. Signet ring cell histology is an independent predictor of poor prognosis in gastric adenocarcinoma regardless of tumoral clinical presentation. Ann Surg, 2009, 250(6): 878-887.

Chinese Journal of Respiratory and Critical Care Medicine

Pulmonary lymphangitic carcinomatosis from gastric signet ring cell carcinoma: three cases report and literature review

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