Jinnur Praveen K, Pannu Bibek S, Boland Jennifer M, Iyer Vivek N
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Ann Med Surg (Lond). 2016 Feb 1;6:77-80. doi: 10.1016/j.amsu.2016.01.024. eCollection 2016 Mar.
A diagnosis of 'chronic cough' (CC) requires the exclusion of sinister pulmonary pathology, including infection and malignancy. We present a patient with a 3 month history of CC who had an extensive workup including a normal high resolution computed tomography of the chest (HRCT) 6 weeks prior to consultation at our center. He subsequently developed constitutional symptoms including weight loss and loss of appetite 5 weeks after initial consultation. A repeat HRCT chest and a subsequent whole body PET scan found that he had developed extensive pulmonary lymphangitic carcinomatosis (PLC) from a colon primary. Treatment of the colon cancer resulted in significant decrease in metastatic disease burden and cough resolution. PLC is a very rare cause of 'chronic cough' and incipient/occult PLC presenting with chronic cough and a normal initial HRCT chest has not been previously reported.
“慢性咳嗽”（CC）的诊断需要排除严重的肺部病变，包括感染和恶性肿瘤。我们报告一名有3个月慢性咳嗽病史的患者，在我们中心会诊前6周进行了全面检查，包括胸部高分辨率计算机断层扫描（HRCT）结果正常。初次会诊5周后，他随后出现了包括体重减轻和食欲不振在内的全身症状。重复胸部HRCT及随后的全身PET扫描发现，他已发展为源自结肠原发灶的广泛肺淋巴管癌病（PLC）。结肠癌的治疗使转移性疾病负担显著减轻，咳嗽症状得以缓解。PLC是“慢性咳嗽”非常罕见的病因，此前尚未有以慢性咳嗽起病且初始胸部HRCT正常的早期/隐匿性PLC的报道。
