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Lymphangitic carcinomatosis — SCE Respiratory MCQ

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ModerateImagingLymphangitic carcinomatosisSCE Respiratory

A 69-year-old woman with breast cancer develops progressive dyspnoea and dry cough. CT shows smooth and nodular interlobular septal thickening, peribronchovascular thickening and small pleural effusions. Echocardiography is normal and BNP is not raised. Antibiotics have not improved symptoms. What is the most likely diagnosis?

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Correct answer: D — Pulmonary lymphangitic carcinomatosis

Nodular septal and peribronchovascular thickening in a patient with cancer suggests lymphangitic carcinomatosis. Pulmonary oedema usually has smoother septal lines and supportive cardiac findings. The distribution along lymphatics is the imaging clue.

Reference: NICE NG122 Lung cancer; Fleischner Society thoracic imaging glossary