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PubMed1999

[A case report: modified PMUE therapy might be effective for advanced gastric carcinoma with pulmonary carcinomatous lymphangitis].

A regimen featuring a combination of CDDP, MMC, 5-FU and ETP (Modified-PMUE) was given to a patient with advanced gastric cancer containing pulmonary carcinomatous lymphangitis. This procedure made his carcinomatous lymphangitis disappear and primary and metastatic lesions reduce in size. The subsequent palliative reduction surgery for gastric carcinoma, proximal gastrectomy was feasible. Nevertheless, postoperative Modified-PMUE was ineffective: carcinomatous lymphangitis reappeared and progressed to death of respiratory failure postoperative 68 days. The SDI test, a sensitivity test for carcinostatic agent showed neither CDDP, MMC, 5-FU nor ETP sensitive to resected carcinoma cells. Therefore, we concluded that the Modified PMUE kills carcinoma cells sensitive to the agents and allows carcinoma cells resistant to the agents to grow.

Adenocarcinoma↗
PubMed2000

[Nodular lymphangitis caused by Nocardia asteroides].

BACKGROUND: Nocardia species are typically found in soil and decaying organic matter. The lymphocutaneous type or nodular lymphangitis is unusual. This is acquired in most of cases by a traumatic inoculation through the skin of a person who is immunocompetent, and is generally caused by Nocardia brasiliensis. METHODS: We report two cases of nodular lymphangitis caused by Nocardia asteroides, that have been admitted in our hospital during one year period. RESULTS: The two healthy persons of 26 and 56 years old suffered from a cutaneous puncture in their arms caused by a plant's pricke while they were gardening. The symptoms they showed at the area of the puncture were ulcerative lesion and inflammatory nodules through the lymphatic tract that were abscessed. There were not any systemic involvement. Cultures of the purulent drainage and skin biopsy revealed Nocardia asteroides. Treatment with oral trimethoprim-sulfamethoxazole for 8 weeks and surgical debridement resulted in a cure without relapse. CONCLUSION: Nodular lymphangitis has specific symptoms and clinical signs. A detailed clinical and occupational history, accompanied by microbiology identification at the cutaneous biopsy and exudation, should allow specific treatment. Trimethoprim-sulfamethoxazole continues being the selected antibiotic.

Adult↗
PubMed2001

Acute lymphangitis mimicking mechanical neck pain.

OBJECTIVE: To discuss acute lymphangitis as a potentially serious infection that can mimic mechanical musculoskeletal pain. CLINICAL FEATURES: A 27-year-old male plant worker had right-sided neck pain. Numerous lesions on the patient's scalp were observed, but were not considered to be related to the chief complaint. INTERVENTION AND OUTCOME: Conservative therapy was initiated to address what was thought to be mechanical neck pain. Shortly after the initial visit, it became evident that the source of the neck pain was infection because lymphangitis developed. Antibiotic therapy was initiated and complete resolution of the complaint occurred within 1 week. CONCLUSION: Primary contact practitioners should consider all aspects of the patient history and physical findings when formulating a diagnosis. This is especially important in the case of patients presenting with lymphangitis because mismanagement could have serious consequences. The importance of a good patient history and team approach to care is demonstrated by this case.

Acute Disease↗
PubMed2003

[A case of advanced gastric cancer with lymphangitis carcinomatosa of the lung, successfully treated with paclitaxel and TS-1].

A 65-year-old man, who had been admitted to another hospital with complaints of severe cough and dyspnea, was transferred to our hospital for the further examination and therapy. The patient was diagnosed with advanced gastric cancer (type-3) with lymphangitis carcinomatosa of the lung. He was treated with combination therapy of 5-FU and cisplatin, and showed a complete response. However, because resistance was seen in the lymphangitis of the lung and the gastric lesion; and a liver metastasis was also seen, we attempted combination therapy with paclitaxel and TS-1. Sixty mg/m2/day of paclitaxel was administered intravenously on day 1 and 8, and TS-1 of 60-80 mg/m2/day was administered orally for 2 weeks followed by one drug-free week. After 2 courses of the combination therapy, the patient achieved a remarkable response in the lymphangitis carcinomatosa of the lung, but a slight response in the liver metastasis and gastric lesion.

Aged↗
PubMed2004

[A case of carcinomatous lymphangitis of the lungs due to stomach cancer responding to TS-1].

We report a case of carcinomatous lymphangitis of the lungs due to and stomach cancer showing remarkable response to TS-1. The patient was a 51-year-old man whose chest x-ray and computed tomography (CT) revealed lymphangitis, and endoscopic examination showed stomach cancer on posterior wall of stomach body. Bone marrow metastasis was suspected because platelet count was 50/microliter, and myelocytes and metamyelocytes emerged in peripheral blood. TS-1 80 mg/day was administered orally for 28 days as 1 course. After 4 courses of TS-1, chest x-ray showed remarkable improvement, and platelet count was normalized. The patient survived for 10 months after the first visit. We suggest that TS-1 is an effective therapy for carcinomatous lymphangitis of the lungs due to stomach cancer.

Adenocarcinoma↗
PubMed1979

[Carcinomatous lymphangitis of the lung. Report of 21 cases (author's transl)].

Twenty-one cases of carcinomatous lymphangitis of the lung are reported. In diagnosing them clinical, roentgenologic, and histopathologic criteria were used and the clinical, roentgenologic and evolutive findins were considered in order to emphasize the origin of the primitive neoplasm. From this point of view the principal ones turned out to be carcinomas of the breast, stomach, and lung. The absence of carcinoma of the thyroid gland as a source of pulmonary lymphangitis carcinomatosa must be pointed out. The higher incidence of this condition in older people and the clear predominance in the female sex are stressed. From a clinical standpoint the most important data were the existence of cough and dyspnea, which are often associated with the commom presence of enlarged left supraclavicular or axillary lymph nodes. There was a predominant pure interstitial pattern (the most common feature was the presence of Kerley's A or B lines), sometimes coexisting with alveolar impairment and very often with accompanying pleural effusion. The mean survival rate was 2 months, with a maximum of 7 months and a minimum of 3 days. The results of the present series were compared with those of the literature and the most significant and constant fact in both instances was that two thirds of the cases of pulmonary lymphangitis carcinomatosa had their origin in neoplasms of the breast, stomach, and lung.

Adult↗
PubMed1977

Benign transient lymphangiectasis (sclerosing lymphangitis) of the penis.

The literature on benign transient lymphangiectasis of the penis (BTLP) was reviewed; reports of 45 cases were collected and a further series, comprising 21 cases, is presented. Both the published and present series support the view that BTLP is associated with recent sexual activity; little support is given for an infective cause and it is confirmed that BTLP is a benign, self-limiting condition presenting in the sexually active man between 20 and 40 years old. There can be recurrences, and susceptibility to them may be encouraged by circumcision in which disturbances of lymphatic drainage may play a part. As so few cases have been reported and few were diagnosed in the present series these comments can only be pointers to further studies. The descriptions in six histological examinations, the reports as `phlebitis' of apparently similar lesions, the report of `sclerosing lymphangitis' in other sites, and the known histological similarity between veins and lymphatics suggest that `sclerosing lymphangitis' is too specific a term. Until further knowledge is available, we suggest that this condition is best regarded as simple dilatation of a lymphatic vessel-namely, lymphangiectasis. As the condition is both benign and transient we propose the term benign transient lymphangiectasis of the penis for the condition formerly known as sclerosing lymphangitis.

Adolescent↗
PubMed1994

Lymphangitis carcinomatosis of the lesser omentum: a prognostic factor in gastric cancer.

A series of 126 patients with gastric cancer who underwent radical gastrectomy with systemic lymph node dissection revealed 9 patients who survived for a median time of only 3 months. Of these 9 patients, 4 were classified by the UICC system as stage II and 5 as stage III, all of whom had lymphangitis carcinomatosis of the lesser omentum. These data suggest that although lymphangitis carcinomatosis of the lesser omentum is an uncommon finding, if it is present, curative surgery is impossible and an operation should therefore be limited to tumor palliation.

Adult↗
PubMedDate not supplied

Obstructive jaundice caused by lymphangitis carcinomatosa of bile duct wall from gastric carcinoma.

We report a case of advanced gastric carcinoma presenting with obstructive jaundice. Computed tomography showed marked lymphadenopathy in the hepatoduodenal ligament and concentric bile duct wall thickening. Histologically, extrahepatic bile duct wall was thickened due to submucosal lymphangitic spread of gastric carcinoma (lymphangitis carcinomatosa). Lymphangitis carcinomatosa may be considered when extrahepatic bile duct wall thickening is seen in patients with obstructive jaundice.

Adenocarcinoma↗
PubMed2006

Histofarcin test for the diagnosis of epizootic lymphangitis in Ethiopia: development, optimisation, and validation in the field.

Histofarcin, a skin test antigen for the diagnosis of epizootic lymphangitis, was locally produced from the mycelial form of Histoplasma capsulatum var. farciminosum (HCF) in disease-endemic districts of Ethiopia and tested for its application in the field between April 2002 and May 2003. The test was evaluated using 108 mules, 84 in endemic and 24 in disease-free districts. Microscopic and mycological examinations of clinical lesions were used as the "gold standard" for the validation of the test. The concentration of histofarcin that caused an optimum reaction was 0.2-0.4 mg/mL in a 0.1 mL dose and this was attained 24-48 h post-injection. The sensitivity and specificity of the histofarcin test were 90.3% (CI = 73.1, 97.5) and 69% (95%, CI = 48.1, 84.9%) in disease-endemic districts. On the other hand, specificity was 100% (CI=94.8, 100) in disease-free districts. Positive and negative predictive values of the histofarcin test were 77.78% (95% CI = 60.4, 89.3) and 85.71% (95% CI = 62.6, 96.2), respectively. A marginal substantial agreement (kappa = 0.61, P = 0.0000) was observed between the clinical status and the result of the histofarcin test. A large proportion (31%) of 'false positives' was recorded in endemic districts, which could be due to the pre-clinical stage of the disease. The latter ended in lower specificity and positive predictive value of the test since the true infection status of a 'false positive' could not be known on the basis of clinical features. Therefore, standard test validation procedures including slaughtering and isolation of HCF is required. After proper validation, we conclude that the histofarcin test could play a significant role in detecting early infection, and differentiating of EL from glanders, ulcerative lymphangitis, and sporotrichosis.

Animals↗
PubMed2005

The importance of histology in the evaluation of pulmonary transplantation: carcinomatous lymphangitis.

Pulmonary carcinomatous lymphangitis is a form of neoplastic metastatic spread to the lungs, which represents a poor prognosis for the patient. The physician may be confronted by a differential diagnosis with diffuse pulmonary interstitial affections requiring specific treatment, including lung transplantation. We present the case of a patient, diagnosed with pulmonary interstitial disease with rapidly progressive worsening of lung function, who was considered for lung transplantation. Videothoracoscopic lung biopsy demonstrated the existence of carcinomatous lymphangitis, which completely changed the therapeutic direction.

Contraindications↗
PubMed2002

Lymphangitis of the foot demonstrating lymphatic drainage pathways from the sole.

BACKGROUND: There are two main lymphatic routes from the lower extremity: the fibular route to the popliteal node and the tibial route to the distant groin node. However, little is known about lymphatics from the sole. OBJECTIVE: We attempted to obtain detailed knowledge of the lymphatics from the sole. METHODS: Eight patients with lymphangitis were examined and compared with the drainage patterns visualized by blue-dye injection in 7 cases of melanoma. RESULTS: Six lymphangitic streaks started from the lateral edge of the plantar surface, 2 from the heel, and 1 each from the center of the sole and the little toe. All streaks ran to the tibial side and went up along the foot branch of the great saphenous vein. These findings were similar to those of the dye-injected melanoma cases. CONCLUSION: Lymphangitis makes visualization of lymphatic routes possible and may provide useful information about drainage.

Adult↗
PubMed2001

Sporotrichoid lymphangitis due to group A Streptococcus.

We describe what is, to our knowledge, the first case of sporotrichoid lymphangitis caused solely by group A Streptococcus in an otherwise healthy patient. Infection with pyogenic pathogens, such as streptococci and staphylococci, as well as with the most common causes of sporotrichoid lymphangitis (i.e., Sporothrix schenkii, Nocardia brasiliensis, Mycobacterium marinum, and Leishmania species) should be considered in differential diagnosis for some patients.

Humans↗
PubMed2000

[A very elderly autopsy case of cecal cancer with pulmonary lymphangitis carcinomatosa].

A 91-year-old man was admitted with colliquative diarrhea, anorexia and weight loss. He had a history of healed tuberculosis, hypertension and atherosclerotic abdominal aortic aneurysms. On admission, shortness of breath without cough, exertional dyspnea, and ascites were also noticed. His chest X-ray and CT showed almost normal findings in the lung fields except for calcified old pleurisy. Since laboratory tests revealed thrombocytopenia, low fibrinogen, and increased CA19-9. DIC induced by an unknown cancer was diagnosed. He died on the eighth day due to progressive respiratory failure which did not respond to oxygen therapy. Autopsy revealed that he had a poorly differentiated adenocarcinoma in the cecum complicated with pulmonary lymphangitis carcinomatosa. Lymphangitis should be considered in the case of unexplained progressive respiratory failure developing in patient with cancer, even in the absence of X-ray findings.

Adenocarcinoma↗
PubMed2000

[Mycobacterium marinum nodular lymphangitis].

BACKGROUND: Mycobacterium marinum has been recognized for some forty years. It generally occurs after trauma in a patient who manipulates tropical fish living in an aquarium. CASE REPORT: We report the case of an exotic fish seller who developed M. marinum nodular lymphangitis after being bitten by one of the fish. DISCUSSION: Nodular lesions occurring after trauma in subjects living in France who are in contact with exotic fish suggest the diagnosis of M. marinum. Nodular lymphangitis is seen in about 50% of the cases. Prolonged antibiotic therapy is required. Several antibiotics are effective including minocycline used in our case for 2 months after complete healing of the wound. Surgery is exceptionally required.

Adult↗
PubMed2003

[A case of gastric cancer with metastasis to cervical lymph nodes and pulmonary lymphangitis carcinomatosa responding to neoadjuvant chemotherapy with TS-1 and CDDP].

The patient was a 61-year-old man who had gastric cancer with metastasis to cervical lymph nodes and pulmonary lymphangitis carcinomatosa. He received daily oral administration of 120 mg of TS-1 (day 1-21) and systemic administration of 100 mg of CDDP (day 8) as one treatment course. As the metastatic lesions had disappeared after chemotherapy, he underwent total gastrectomy. Histopathological examination of resected regional lymph nodes revealed marked fibrosis and a small amount of scattered cancer cells. Although much peritoneal dissemination was observed macroscopically, histopathological examination of these tumors revealed only fibrosis with no cancer cells. These findings supported the effect of this neoadjuvant chemotherapy. He died of recurrence of the carcinoma 203 days after surgery, without any sign of recurrence of metastasis to cervical lymph nodes or pulmonary lymphangitis carcinomatosa.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[A case of adenocarcinoma of lung cancer with multiple brain metastasis and lymphangitis carcinomatosa responding well to chemotherapy with carboplatin, etoposide and ifosfamide].

A 75-year-old male who suffered from adenocarcinoma of lung cancer with multiple brain metastases, developed left hemiplegia. After diagnosis, he was treated with 4,000 cGy whole brain radiation, but soon after advanced lymphangitis carcinomatosa set in and his general condition deteriorated. He was administered carboplatin combination with etoposide and ifosfamide. Lymphangitis carcinomatosa disappeared, and the main tumor of lung and brain metastases were not growing. We recommended carboplatin for an old patient or one in poor condition, because it had less cytotoxicity and retained the same antitumor activity compared with cisplatin.

Adenocarcinoma↗
PubMedDate not supplied

Asymptomatic lymphangitis carcinomatosis due to squamous cell lung carcinoma.

Lymphangitis carcinomatosa most commonly due to primary malignancy originating in the breast, stomach, pleura and prostate but may also originate from the lung itself. It is clinically characterised by progressing dyspnoea with or without cough even at an early stage. We report the case of a patient with squamous cell lung cancer presenting with asymptomatic lymphangitis carcinomatosa.

Biopsy, Needle↗