Case Report

The 'Fragmented' Scintigraphic Lung Pattern in Pulmonary Lymphangitic Carcinomatosis Secondary to Breast Cancer
Angelo G. Vattimo, Luca Burroni, Paolo Bertelli, Alessandra Vella, Duccio Volterrani

Department of Nuclear Medicine, University of Siena, Italy

Address of Corresponding Author

Respiration 1998;65:406-410 (DOI: 10.1159/000029304)

  Key Words

• Lymphangitic carcinomatosis, pulmonary
• Dyspnea
• Breast cancer
• Scintigraphy, pulmonary
• Technetium-99m macroaggregated albumin

  Abstract

Pulmonary lymphangitic carcinomatosis (PLC) is an unusual presentation of diffuse infiltrative lung disease. In this report we present two cases secondary to breast cancer; the diagnosis was made by means of transbronchial lung biopsy or postmortem examination. The goal of this study was to analyze the scintigraphic pattern of pulmonary perfusion performed with technetium-99m macroaggregated albumin (^99mTc-MAA) in the hope of achieving improved recognition of PLC and its subsequent diagnosis. Upon admission, both patients underwent routine clinical exams followed by chest X-rays. The second patient also underwent CT examination, and both were ultimately examined using pulmonary perfusion scintigraphy with ^99mTc-MAA. In the various exams performed, the most reliable and easily identified diagnostic finding turned out to be a characteristic 'fragmented' lung pattern revealed with the perfusion lung scan. Unfortunately, in both cases the patients' conditions rapidly worsened and death occurred shortly following scintigraphy. We were able to conclude that the recognition of the mentioned fragmented scintigraphic lung pattern may be useful in suspected PLC, whereas the nonspecific clinical presentation of this pathology makes diagnosis extremely difficult, with the most significant results being achieved through a comparison of scintigraphic and high resolution CT data.

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  Author Contacts

Dr. Luca Burroni, MD
Department of Nuclear Medicine, University of Siena, Le Scotte Hospital
Viale Bracci
I-53100 Siena (Italy)
Tel. +39 577 585 708, Fax +39 577 586 193, E-Mail vattimo@unisi.it

  Article Information

Received: Received: May 29, 1997
Accepted: September 29, 1997
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 0, Number of References : 17

  Publication Details

Respiration (International Review of Thoracic Diseases)
Founded 1944 as 'Schweizerische Zeitschrift für Tuberkulose und Pneumonologie' by E. Bachmann, M. Gilbert, F. Häberlin, W. Löffler, P. Steiner and E. Uehlinger, continued 1962-1967 as 'Medicina Thoracalis'

Vol. 65, No. 5, Year 1998 (Cover Date: September-October 1998)

Journal Editor: C.T. Bolliger, Basel; H. Zerzog, Basel
ISSN: 0025-7931 (print), 1423-0356 (Online)

For additional information: http://www.karger.com/journals/res

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