Pulmonary lymphangitic carcinomatosis without concurrent liver metastasis from colon cancer detected using 18F-FDG PET/CT

Figures

• 

  Figure 1. The 18F-FDG PET/CT examination. The maximum intensity projection image (A) showed abnormal FDG uptake in the mediastinal nodes (thin arrows) and right lung (thick arrows). Axial chest images showed, increased FDG uptake in the superior segment of the right lower lobe (B–D) along the slightly thickened bronchovascular bundles (thick arrows, SUVmax=2.7), in bilaterally scattered ground-glass opacities (E–G, thick arrows, SUVmax = 3.7), and in paratracheal and para-aortic lymphadenopathy (H–J, thick arrows, SUVmax, 6.3). 18F-FDG PET/CT = 18F-fluorodeoxy glucose positron emission tomography/computed tomography.

• 

  Figure 2. Histopathology revealed that biopsy specimens of the opening of right inferior lobar bronchus (A, hematoxylin-eosin stain; original magnification, × 400) and mediastinal lymph nodes (B, hematoxylin-eosin stain; original magnification, × 400) were composed of marked atypia of epithelialcells. Immunohistochemical staining demonstrated tumor cells were positive for CK20 (C, original magnification, × 400) and CDX-2 (not shown), but negative for CK7 (D, original magnification, × 400). 18F-FDG PET/CT = 18F-fluorodeoxy glucose positron emission tomography/computed tomography.

• 

  Figure 3. Chest high-resolution computed tomography (HRCT) shows the bilateral areas of diffusely thickened interlobular septa, the thickening of bronchovascular bundles (A–C, thick arrows), the presence of enlarged mediastinal nodes (D, thick arrows), and pleural effusion (D, asterisk). All these features indicate progression of disease.