An unusual cause of chest pain

Symptoms of exertional dyspnoea are common and can precede other symptoms of malignancy. 3 Viral pneumonia, pulmonary oedema, and sarcoidosis are potential differential diagnoses based on the radiograph appearance. In view of this patient's collapse episode and raised serum D-dimer, a CT pulmonary angiogram was performed, which showed a mass in the right upper lobe with extensive septal thickening consistent with lymphangitis carcinomatosa throughout the right lung, alongside adrenal metastasis (fig 2 ). CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests.