Chest imaging: lymphangitic carcinomatosis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest imaging: lymphangitic carcinomatosis

Sample item

A woman with known breast carcinoma is breathless. HRCT shows nodular, beaded thickening of the interlobular septa and bronchovascular bundles, more marked on the right, with preserved lung architecture. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Lymphangitic carcinomatosis

Tumour spread through pulmonary lymphatics thickens the septa and peribronchovascular interstitium in a beaded, nodular manner, often asymmetrically. It is common with breast, lung, stomach and pancreatic primaries.

Option by option

  • A. Usual interstitial pneumonia

    UIP shows basal subpleural honeycombing and traction bronchiectasis.

  • B. Acute lobar pneumonia

    Lobar pneumonia produces consolidation rather than septal thickening.

  • C. Pulmonary alveolar proteinosis

    Alveolar proteinosis shows crazy paving with geographic sparing.

  • D. Lymphangitic carcinomatosis (correct)

    Correct. Beaded septal thickening with preserved architecture is typical.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Lymphangitic carcinomatosis. Tumour spread through pulmonary lymphatics thickens the septa and peribronchovascular interstitium in a beaded, nodular manner, often asymmetrically.

Why is "Usual interstitial pneumonia" not the answer?

UIP shows basal subpleural honeycombing and traction bronchiectasis.

Why is "Acute lobar pneumonia" not the answer?

Lobar pneumonia produces consolidation rather than septal thickening.

Why is "Pulmonary alveolar proteinosis" not the answer?

Alveolar proteinosis shows crazy paving with geographic sparing.

What concept does this question test?

It tests Chest imaging: lymphangitic carcinomatosis in Radiology. It is common with breast, lung, stomach and pancreatic primaries.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest imaging: lymphangitic carcinomatosis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.