CTICasesRenal Cell Carcinoma with Lymphangitic Carcinomatosis
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Imaging findings
Chest radiograph showed dramatic septal lines at the bases, likely a right pleural effusion, thickening of fissures, and an ill-defined lobar abnormality in the left lung. CT scan confirmed dramatic septal lines with a pronounced nodular component, and a mass-like abnormality in the left lung extending into the hilum and mediastinum, narrowing the left pulmonary artery. A renal mass on the left was also identified.
Key takeaways
Florid septal lines should prompt consideration of edema, but with an associated mass, lymphangitic carcinomatosis becomes a key differential. Renal cell carcinoma is a known cause of lymphangitic metastasis. Lymphangitic carcinomatosis can cause severe shortness of breath, often disproportionate to the radiographic findings in its early stages. The nodular component of septal thickening helps differentiate tumor from simple edema.
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