Martínez Avilés P, Perpiñá M, Solís Villa J, Valiente Velasco B
Servicio de Medicina Interna y Neumología, Hospital Severo Ochoa, Leganés, Madrid.
An Med Interna. 1994 Aug;11(8):377-80.
We analyze the clinical characteristics, the diagnostic criteria and the radiological aspects of 10 cases of Carcinomatous Lymphangitis. The quickly progressing exercise dyspnea and the constitutional syndrome were the most frequent symptoms. In nine patients, the tumor was previously unknown. The image methods (adbominal CAT and Echography) and the fibrobronchoscopic exam allowed a correct diagnosis. The most frequent neoplasia had a pulmonary origin and the most frequent histology was adenocarcinoma. The histological tests (bronchial and transbronchial biopsies) were more effective for the diagnosis than the cytological test (bronchoalveolar lavage, bronchoaspiration and bronchial brushing), although these were complemented. The radiology showed a reticulo-linear pattern in all the cases. The finding of macroscopic disorders in the fibrobronchoscopy, the presence of a local infiltration or a node/mass image in the thoracic radiography were highly suggestive of primary pulmonary neoplasia.
我们分析了10例癌性淋巴管炎的临床特征、诊断标准及影像学表现。快速进展的运动性呼吸困难和全身症状是最常见的症状。9例患者此前未发现肿瘤。影像检查方法（腹部CT和超声检查）及纤维支气管镜检查可作出正确诊断。最常见的肿瘤起源于肺部，最常见的组织学类型为腺癌。组织学检查（支气管及经支气管活检）对诊断的有效性高于细胞学检查（支气管肺泡灌洗、支气管抽吸及支气管刷检），不过细胞学检查起到了辅助作用。所有病例的影像学表现均为网状线性模式。纤维支气管镜检查发现肉眼可见的病变、胸部X线片显示有局部浸润或结节/肿块影像，高度提示原发性肺部肿瘤。
