文献类型：期刊文献

英文题名：Pulmonary lymphangitic carcinomatosis and pathological fracture as the initial manifestations of occult gastric adenocarcinoma mimicking interstitial lung disease: a case report and review of the literature

作者：Yan, Yan-Feng[1];Qi, Wen-Xia[2];Tian, Jie-Xiang[2];Wei, Cai-Hong[1];Cui, Yong-Hui[1]

第一作者：Yan, Yan-Feng

通信作者：Wei, CH[1]

机构：[1]Gansu Univ Chinese Med, Affiliated Hosp 4, Lanzhou Petrochemical Gen Hosp, Dept Resp & Crit Care Med, Lanzhou, Gansu, Peoples R China;[2]Gansu Univ Chinese Med, Affiliated Hosp, Dept Rheumatol & Bone Dis, Lanzhou, Gansu, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Affiliated Hosp 4, Lanzhou Petrochemical Gen Hosp, Dept Resp & Crit Care Med, Lanzhou, Gansu, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：13

外文期刊名：FRONTIERS IN MEDICINE

收录：;WOS:【SCI-EXPANDED(收录号:WOS:001895586200001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. This work was supported by the National Natural Science Foundation of China (Grant Nos. 81860858 and 81960832); the Natural Science Foundation of Gansu Province (Grant Nos. 22JR11RA131 and 24JRRA1038); the Construction Project of the National Administration of Traditional Chinese Medicine-Evidence-Based Capacity Building Project of Traditional Chinese Medicine (Grant No. 2101704); the Inheritance Studio Construction Project of Famous Traditional Chinese Medicine Experts in Gansu Province (Grant No. 2100601); the Scientific Research Project of the Health Industry of Gansu Province (Grant No. GSWSQN-2024-08); and the High-Level Key Project of the Gansu Provincial Administration of Traditional Chinese Medicine (Grant No. GZKZ-2025-37).

语种：英文

外文关键词：EBUS-TBNA; gastric adenocarcinoma; interstitial lung disease; pathological fracture; pulmonary lymphangitic carcinomatosis; signet-ring cell

摘要：Background Pulmonary lymphangitic carcinomatosis (PLC) clinically and radiologically mimics interstitial lung disease (ILD), posing diagnostic challenges when the primary malignancy is occult.Case presentation A 33-year-old male presented with progressive cough, dyspnea, and a rib fracture following minimal trauma. Chest CT showed bilateral interlobular septal thickening and mediastinal lymphadenopathy. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of subcarinal nodes confirmed metastatic adenocarcinoma, with immunohistochemistry (CK7+,TTF-1-, Napsin A-) suggesting gastrointestinal origin. Subsequent PET-CT and gastroscopy identified a 4.0 cm gastric angulus tumor, biopsied as moderately to poorly differentiated adenocarcinoma with signet-ring cells. Despite first-line and second-line chemotherapy with transient improvement, rapid progression ensued. The patient died on February 18, 2025, with an overall survival of approximately 6 months from metastatic diagnosis.Conclusion This case illustrates that in young patients with ILD-like imaging and low-energy fractures, PLC warrants consideration even without gastrointestinal symptoms. Early use of EBUS-TBNA and PET-CT may facilitate timely diagnosis in appropriate clinical settings. Signet-ring cell-associated PLC carries a dismal prognosis, and transient responses should not be misconstrued as long-term benefit.