Information
Carcinomatosis lymphangitis is infiltration and obstruction of the pulmonary lymphatic system. It can occur with all malignancies but is most common with adenocarcinomas particularly breast, lung, colon and stomach cancers.
Most common symptoms are breathlessness, cough and haemoptysis.
Unfortunately prognosis is poor with less than 50% of patients surviving more than 3 months.
If lymphangitis is confirmed, treatment is often symptomatic with corticosteroids and often palliative care input. However, many other conditions may mimic lymphangitis, such as atypical infections, radiation pneumonitis and drug-induced pneumonitis. Therefore, discussion with oncology is always recommended if lymphangitis is suspected.’
M.A, K.E & J.W 12-02-26
Who to refer:
Patients with a cancer diagnosis and symptoms suggestive of lymphangitis.
Who not to refer:
If in doubt please do not hesitate to call. Depending on the patient’s prognosis and wishes a trial of steroids in the community may be recommended.
How to refer:
Contact the Acute Oncology team at the Edinburgh Cancer Centre on 07798774842 or 0131 537 1000 and ask to speak to Acute Oncology team for oncology.
All patients on or within six weeks of treatment should be encouraged to monitor symptoms and call The Cancer Treatment Helpline (CTH; 08009177711) with any treatment-related concerns. Please note, the CTH is a call operator service provided by NHS 24, who then refer on to an acute care specialist. They cannot give specialist advice.
If the patient has been assessed by a healthcare practitioner in Primary Care, and Oncology advice/input is felt to be required, the Primary Care clinician should call the Acute Oncology team at the Edinburgh Cancer Centre (based in the WGH) and discuss directly. The Acute Oncology team can be contacted during working hours (Mon-Fri 9-5) on 07798774842; If out of hours, please discuss with the Oncology Registrar On-Call via NHS Lothian Switchboard (0131 537 1000).
If the primary care clinician requires any further guidance on the suitability of referral to Acute Oncology, they can consult Pg 10 of the The UKONS Oncology/Haematology 24 Hour Triage Toolkit.
Note if a patient has presented to primary care for assessment, the patient should NOT be advised to call the CTH themselves to pass on this information or seek further advice.
Link to Acute Oncology Initial Management Guidelines:
UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)
