• Taro Funakoshi, Hirofumi Yasui, Narikazu Boku, Akira Fukutomi, Kentaro Yamazaki, Nozomu Machida, Akiko Todaka, Takahiro Tsushima, Tomoya Yokota, Yusuke Onozawa, Hirotsugu Kenmotsu, and Masahiro Endo.
• Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Nagaizumi-tyo Department of Clinical Oncology, Kyoto University Hospital Cancer Center, Kyoto tarofun@kuhp.kyoto-u.ac.jp.
• Jpn. J. Clin. Oncol. 2014 Sep 1; 44 (9): 792-8.

ObjectiveBreast, gastric and lung cancers are the most common cancers that cause pulmonary lymphangitis carcinomatosa. However, little is known about the clinical features of pulmonary lymphangitis carcinomatosa in advanced gastric cancer.MethodsWe retrospectively reviewed the data throughout the clinical courses of 33 patients with gastric cancer who developed pulmonary lymphangitis carcinomatosa. Pulmonary lymphangitis carcinomatosa was confirmed by both a pulmonologist and a diagnostic radiologist on the basis of computed tomography findings of interstitial patterns such as thickening or irregularity of interlobular septa and bronchovascular bundles.ResultsThe median age of the 33 patients was 55 years old (range, 25-73 years). The percentages of female patients, those with performance status 3 or 4, and those with respiratory symptoms at diagnosis were 70, 36 and 76%, respectively. The histologically diffuse type of gastric cancer accounted for 85% of cases. Mediastinal lymph node, peritoneal and bone metastases were found in 64, 61 and 39% of patients, respectively. Disseminated intravascular coagulation was noted in 21% of patients. The median survival time of the 18 chemotherapy-naïve patients treated with chemotherapy was 5.7 months (range, 0.4-37.0 months). Two patients obtained symptomatic relief, and one patient treated with S-1 + cisplatin + sunitinib survived >3 years.ConclusionsPulmonary lymphangitis carcinomatosa caused by gastric cancer has some specific clinicopathological features. While the prognosis of gastric cancer patients with pulmonary lymphangitis carcinomatosa is extremely poor, some patients may have survival benefit from chemotherapy.© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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