Saini Tanjot, Bekal Sundeep, Liman Andrew D
Internal Medicine, University of California San Francisco Fresno, Fresno, USA.
Hematology and Oncology, Fresno VA Medical Center, Fresno, USA.
Cureus. 2023 Mar 11;15(3):e36030. doi: 10.7759/cureus.36030. eCollection 2023 Mar.
Urothelial cancer with lymphangitic carcinomatosis is a rare clinical phenomenon that is not commonly associated with acute respiratory failure. However, the recent prevalence of COVID-19 may predispose a patient's respiratory system to become more susceptible to metastatic lymphangitic spread. We present a case of a 57-year-old male with progressively worsening hypoxic respiratory failure after testing positive for COVID-19 six months prior. Imaging during the hospitalization showed adenopathy consistent with lymphangitic carcinomatosis that was not present six months prior. Acute respiratory deterioration is associated more commonly with infection rather than the progression of cancer, but infectious, autoimmune, and cardiac processes were deemed minimal contributory factors. The patient's respiratory decline only allowed for a T-11 vertebral biopsy which showed poorly differentiated metastatic carcinoma of possible urothelial origin. Urothelial cancer leading to respiratory failure due to lymphangitic carcinomatosis is an uncommon phenomenon, but in the setting of prior COVID-19, it may make the respiratory system more susceptible to lymphangitic spread. However, research is limited due to the recent prevalence of COVID-19, and more research is necessary to investigate a potential correlation with rapid lymphatic carcinomatosis after COVID-19 infection.
伴有淋巴管癌病的尿路上皮癌是一种罕见的临床现象，通常与急性呼吸衰竭无关。然而，近期新冠病毒病（COVID-19）的流行可能使患者的呼吸系统更容易受到转移性淋巴管扩散的影响。我们报告一例57岁男性病例，该患者在6个月前新冠病毒检测呈阳性后，出现进行性加重的低氧性呼吸衰竭。住院期间的影像学检查显示存在与淋巴管癌病相符的腺病，而6个月前并不存在。急性呼吸恶化更常见于感染而非癌症进展，但感染、自身免疫和心脏疾病被认为是极小的促成因素。患者的呼吸功能下降仅允许进行T-11椎体活检，结果显示为可能起源于尿路上皮的低分化转移性癌。因淋巴管癌病导致呼吸衰竭的尿路上皮癌是一种不常见的现象，但在既往感染过新冠病毒病的情况下，可能会使呼吸系统更容易受到淋巴管扩散的影响。然而，由于近期新冠病毒病的流行，相关研究有限，需要更多研究来调查新冠病毒感染后与快速淋巴管癌病之间的潜在关联。
