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CASO CLÍNICO

CASO CLÍNICO. Varón 74 años, hace 2 meses astenia, tos seca persistente, hiporexia. No fiebre, no disnea. HOSPITAL UNIVERSITARIO DE GETAFE. Madrid Karina Rodríguez (1) , Pierina Rubio (2) , Juliana Rodríguez (2) , Joaquín Costa (3 ).

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CASO CLÍNICO

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  1. CASO CLÍNICO Varón 74 años, hace 2 meses astenia, tos seca persistente, hiporexia. No fiebre, no disnea. HOSPITAL UNIVERSITARIO DE GETAFE. Madrid Karina Rodríguez (1), Pierina Rubio(2), Juliana Rodríguez(2), Joaquín Costa(3). (1) MIR 3 Radiodiagnóstico, (2) MIR 2 Radiodiagnóstico, (3) Adjunto Radiodiagnóstico Área Tórax del HUG

  2. 1. ¿Cuál cree es el diagnóstico más probable? A) Insuficiencia cardiaca congestiva. B) Esclerodermia. C) Linfangitis carcinomatosa. D) Sarcoidosis.

  3. 2. Además de la afectación parenquimatosa ¿Qué hallazgos adicionales se aprecian? A) Tromboembolismo pulmonar. B) Adenopatías mediastínicas con calcificación en “cáscara de huevo”. C) Engrosamiento mural gástrico. D) Masa suprarrenal izquierda.

  4. DIAGNÓSTICO • LINFANGITIS CARCINOMATOSA en contexto de adenocarcinoma gástrico pobremente diferenciado. • EVOLUCIÓN: Progresión de su enfermedad de base a pesar del tratamiento quimioterápico. • BIBLIOGRAFÍA: • JunpeiIkezoe, J. David Godwin. PulmonaryLymphangitisCarcinomatosis. Chronicity of Radiographic Findings in Long-Term. AJR 1995;165:49-52. • Davis S.D. CT evaluation for pulmonary metastases in patients with extrathoracic malignancy. Radiology. 1991 Jul;180(1):1-12. • Stein MG et al. “Pulmonary lymphangitic spread of carcinoma: appearance on CT scans.” Radiology 1987 Feb;162(2):371-5 • Webb, WR . Thin--Section CT of the Secondary Pulmonary Lobule: Anatomy and the Image - The 2004 Fleischner Lecture. Radiology 2006;239:322--338

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