Pulmonary Lymphangitic Carcinomatosis: An Atypical Presentation Leading to Discovery of Multi-Organ Metastasis With Unknown Occult Primary Malignancy.

Pulmonary lymphangitic carcinomatosis is the spread of malignant cells to the lymphatic system in the lungs, which results in inflammation and lymphatic dilation. It is often found to coexist in patients with prior history of malignancy. The clinical presentation is usually related to respiratory symptoms, but atypical presentation can occur. Chest x-ray imaging can be non-revealing at initial stages, and abnormalities may only be appreciated when the disease gets to more advanced stages. Computed tomography imaging can reveal radiological abnormalities that were found to be associated with pulmonary lymphangitic carcinomatosis. More advanced imaging modalities and pathological tissue confirmation may be required for the diagnosis. However, once the diagnosis is made, prognosis remains poor and treatment efforts are geared towards the underlying malignancy. Here, we report on a rare case of pulmonary lymphangitic carcinomatosis in an adult male with no prior history of cancer, for whom his hospitalization led to the discovery of malignancy involving multiple organs.

A Case Report of Successful Medical Management of Emphysematous Gastritis With Portal Venous Air.

Emphysematous gastritis is an uncommon yet life-threatening condition characterized by air in the gastric wall. It requires clinical and radiological findings for its diagnosis. Management is done either medically or surgically and requires early intervention with bowel rest, proton pump inhibitors, and antibiotics with or without gastrectomy secondary to the high mortality associated with the condition. We present a case of a 55-year-old male who responded well to medical therapy without the need for surgical intervention.