Pulmonary lymphangitic carcinomatosis as a primary manifestation of gastric carcinoma in a young adult: a case report and review of the literature

BACKGROUND: Lymphangitic carcinomatosis as a manifestation of gastric carcinoma is rare. The presenting symptoms are misleading and nonspecific, often resulting in delayed diagnosis. CASE PRESENTATION: We present a case of a 24 year old male with progressive dyspnea. Initial radiologic assessment suggested interstitial lung disease, which was subsequently treated with antibiotics and corticosteroids. However, endoscopy and whole body diffusion-weighted magnetic resonance imaging revealed a metastatic gastric cancer with the presence of lymphangitic carcinomatosis. CONCLUSIONS: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic gastric cancer. Patients present with severe but non-specific respiratory complaints. Definitive diagnosis can be achieved by transbronchial biopsy. Prognosis is poor and optimal treatment is not defined. Whole body diffusion-weighted magnetic resonance imaging is a promising imaging tool for the diagnosis of metastatic gastric cancer.