Pulmonary lymphangitic carcinomatosis presenting as severe interstitial lung disease in a 15-year-old female.

A 15-yr-old Caucasian female was transferred to our hospital (Birmingham Children’s Hospital, Birmingham, UK) for further assessment and management of respiratory failure, secondary to presumed interstitial lung disease. 8 weeks previously she had presented to her local hospital with a 5week history of cough and shortness of breath associated with lethargy, poor appetite and early satiety. On examination she was hypoxic with bilateral wheeze and crackles. Bilateral perihilar shadows and increased bronchovascular markings were seen on the chest radiograph. Atypical pneumonia was diagnosed and she received oxygen, oral erythromycin and inhaled salbutamol. She recovered but after discharge required two courses of oral prednisolone and salbutamol for wheeze and shortness of breath.