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Occult pulmonary lymphangitic carcinomatosis presenting as 'chronic cough' with a normal HRCT chest.

Jinnur PK, Pannu BS, Boland JM, Iyer VN - Ann Med Surg (Lond) (2016)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

Baseline chest x-ray.
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fig1: Baseline chest x-ray.

Mentions: A 66 year old non-smoking Caucasian male with a history of post-nasal drip (PND) and long standing gastroesophageal reflux disease (GERD) presented to our pulmonary clinic for evaluation of a persistent dry cough of 3 month duration. Over the past 3 months, he had failed treatment with inhaled fluticasone/salmeterol, fluticasone nasal spray, omeprazole, loratadine as well as a short course of oral prednisone. He denied wheezing, recent upper respiratory tract infection, fevers, night sweats or weight loss. A chest x-ray (Fig.1) and HRCT of his chest (Fig.2) performed 6 weeks before presentation to our clinic were both normal.


Occult pulmonary lymphangitic carcinomatosis presenting as 'chronic cough' with a normal HRCT chest.

Jinnur PK, Pannu BS, Boland JM, Iyer VN - Ann Med Surg (Lond) (2016)

Baseline chest x-ray.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764654&req=5

fig1: Baseline chest x-ray.
Mentions: A 66 year old non-smoking Caucasian male with a history of post-nasal drip (PND) and long standing gastroesophageal reflux disease (GERD) presented to our pulmonary clinic for evaluation of a persistent dry cough of 3 month duration. Over the past 3 months, he had failed treatment with inhaled fluticasone/salmeterol, fluticasone nasal spray, omeprazole, loratadine as well as a short course of oral prednisone. He denied wheezing, recent upper respiratory tract infection, fevers, night sweats or weight loss. A chest x-ray (Fig.1) and HRCT of his chest (Fig.2) performed 6 weeks before presentation to our clinic were both normal.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus