Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 2, Number 2, April 2011, pages 81-86

A Case of Prostate Carcinoma Discovered With Pulmonary Lymphangitis Carcinomatosa


Figure 1.
Figure 1. The chest X-ray in the initial diagnosis.
Figure 2.
Figure 2. High resolution computed tomography (HRCT) of the chest in the initial diagnosis. In the lung fields (A), ground glass and granular opacities are present diffusely around bronchovascular bundle. In the macrophotograph of the right middle lobe and part of lower lobe (B), peribronchovascular interstitial thickening (arrows) and interlobular septa thickening which form a polygon (in the circle) are present. In the mediastinal space condition (C), some mediastinal lymph nodes are slightly enlarged.
Figure 3.
Figure 3. The specimen of trans-bronchial lung biopsy (TBLB) with Hematoxylin and Eosin staining.
Figure 4.
Figure 4. The specimens of TBLB with TTF-1 staining (left) and D2-40 staining (right).
Figure 5.
Figure 5. Pelvic CT showing a remarkably enlarged prostate with heterogeneous interior density.
Figure 6.
Figure 6. PSA staining was positive in the area of colonization of atypical cells (10 X).
Figure 7.
Figure 7. The prostate biopsy showing a poorly differentiated adenocarcinoma and in which Gleason’s score was 8.


Table 1. Blood Examination and Blood Gas Analysis
CBC, complete blood count; WBC, white blood cell; RBC, red blood cell; BBC, blood biochemistry; AST, aspartate aminotransferase; ALT, alanine aminotransferase; LDH, lactate dehydrogenase; γ-GTP, γ-glutamyltranspeptidase; CPK, creatine phosphate kinase; TP, total protein; UA, uric acid; BUN, blood urea nitrogen; Cre, creatinine; Glu, glucose; HbA1c, hemoglobin A1c; CRP, C reactive protein; CEA, carcinoembryonic antigen; sLI-2R, serum interleukin II receptor; PR3, proteinase-3; ANCA, antineutrophil cytoplasmic antibody; MPO, myeloperoxidase; ABG, arterial blood gas analysis; BE, base excess; SaO2, Oxygen saturation.
CBCNormal rangeNormal Range
WBC12600/µl(3900 – 9300)Cre0.92 mg/dl
RBC511 x 104/µlNa141 mEq/L
hemoglobin14.5 g/dlK4.0 mEq/L
hematocrit43.6%Cl99 mEq/L(70 - 109)
platelet19 x 104/µlGlu221 mg/dl(4.3 - 5.8)
HemogramHbA1c8.5%(< 0.3)
neutrophil76%CRP28.4 mg/dl
lymphocyte16.8%CEA0.5 ng/ml
monocyte6.3%Ca 19-911.1 U/ml(124 - 466)
eosinophil0.3%sIL2R564 U/ml
basophil0.6%KL-6257 U/ml
BBCSP-D17.2 ng/ml
T-Bil1.9 mg/dl(0.2 - 1.0)PR3-ANCA< 10 EU
AST95 U/L(5 - 40)MPO-ANCA< 10 EU
ALT48 U/L(5 - 45)ABG
LDH1293 U/L(120 - 240)PH7.464
γ-GTP187 U/L(≤ 85)PCO231 mm Hg(32 - 46)
CPK133 U/LPO279 mm Hg
TP6.8 g/dlHCO3-22.0 mmol/L
UA4.5 mg/dlBE-0.6 mmol/L
BUN25.9 mg/dl(8.0 - 20.0)SaO296.9%