Differential Diagnosis for Lymphangitic Dissemination on a CT Scan

• Single Most Likely Diagnosis
  • Pulmonary Metastases: This is the most common cause of lymphangitic dissemination, where cancer cells spread to the lungs through the lymphatic system, often originating from breast, lung, or gastrointestinal cancers.
• Other Likely Diagnoses
  • Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can cause lymphangitic dissemination, as the disease can spread to the lungs and involve the lymphatic vessels.
  • Sarcoidosis: This autoimmune disease can cause granulomatous inflammation in the lungs, leading to lymphangitic dissemination.
  • Pneumonia: Certain types of pneumonia, such as Mycoplasma or viral pneumonia, can cause lymphangitic dissemination, especially in immunocompromised patients.
• Do Not Miss Diagnoses
  • Tuberculosis: Although less common, tuberculosis can cause lymphangitic dissemination, and missing this diagnosis can have severe consequences due to the need for specific antibiotic treatment.
  • Fungal Infections: Infections such as histoplasmosis or cryptococcosis can cause lymphangitic dissemination, particularly in immunocompromised patients, and require prompt antifungal treatment.
• Rare Diagnoses
  • Lymphangioleiomyomatosis: A rare lung disease that affects mostly women, causing cystic lung lesions and lymphangitic dissemination.
  • Kaposi's Sarcoma: A rare cancer that can cause lymphangitic dissemination, often associated with HIV/AIDS or immunosuppression.
  • Langerhans Cell Histiocytosis: A rare disease that can cause lymphangitic dissemination, characterized by the proliferation of Langerhans cells in the lungs.