We present a case of advanced pancreatic cancer with diffuse pulmonary interstitial infiltrates and dyspnea in a 61-year-old Asian Taiwanese female. Although surgical lung biopsy is the diagnostic gold standard in most interstitial lung disease, it frequently leads to complications in sick patients. Based on the overall clinico-radiologic correlation, a diagnosis of pulmonary lymphangitic carcinomatosis was supported by the characteristic findings in high-resolution computed tomography.