Bard's Syndrome: A Rare Case Presentation of Pulmonary Miliary Metastases of Gastric Carcinoma
H. Arfaoui
Department of Pulmonology, Hospital 20 Août 1953, Casablanca, Morocco.
S. Msika
*
Department of Pulmonology, Hospital 20 Août 1953, Casablanca, Morocco.
M. Zadi
Department of Pulmonology, Hospital 20 Août 1953, Casablanca, Morocco.
H. Jabri
Department of Pulmonology, Hospital 20 Août 1953, Casablanca, Morocco.
W. El Khattabi
Department of Pulmonology, Hospital 20 Août 1953, Casablanca, Morocco.
H. Afif
Department of Pulmonology, Hospital 20 Août 1953, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
The Bard's syndrome is a rare desease related to miliary dissemination of gastric cancer to the lungs. The symptoms of primary neoplasm are subclinic despite the advanced proliferative process, and the metastatic lesions cause many respiratory symptoms suggesting primary pulmonary pathology, which explain the difficulties in diagnosis between numerous diseases. We report the case of a 39-year-old man presented for a chest pain, progressive worsening dyspnea appeared one month ago, dry cough, apyrexia, fatigue and weight loss. The chest CT scan showed a disseminated micronodular lesions, a thickened interlobular septa and mediastinal lymphadenopathy. Flexible bronchoscopy showed a diffuse inflammation on the entire bronchial tree. Staged bronchial biopsies revealed the presence of metastatic carcinoma, stomach in origin. The cytologic examination from bronchial aspirate reveal the presence of neoplasic cells. After re-interviewing the patient, he reported the history of intermittent epigastralgia, so we completed by an oesophageal-gastro-duodenal fibroscopy that confirmed the gastric adenocarcinoma and the diagnosis of bard’s syndrome was made with gastric adenocarcinoma with pulmonary lymphangitic carcinomatosis.
Keywords: Bard’s syndrome, pulmonary miliary metastases, gastric carcinoma