title: Pulmonary lymphangioleiomyomatosis; unusual radiological manifestation of multiple large nodules.
abstract: A 44-year-old woman was admitted to our hospital in August 1999 for multiple large nodules detected on chest roentgenogram in an annual health check. Chest CT scans showed bilateral large nodules (>10 mm in diameter) with irregular margins and multiple thin walled cystic lesions. From these radiologic examinations, we suspected pulmonary Langerhans cell histiocytosis. Histological examination of the biopsy specimen by video-assisted thoracoscopy revealed a marked proliferation of the spindle cells, which were immunologically positive for alpha-smooth muscle actin and HMB-45, in the cyst walls and lung parenchyma. The large nodules consisted of proliferation of the smooth muscle cells surrounded by a dense layer of hemosiderinladen macrophages. During the two years subsequent to these 1999 examinations, the opacities have gradually diminished and the patient was found to have pulmonary lymphangioleiomyomatosis. This case exhibited rare radiologic manifestations of multiple large nodules mimicking Langerhans cell histiocytosis.
authors.affiliation: Third Department of Internal Medicine, Sapporo Medical University School of Medicine.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masanori
authors.initials: M
authors.lastname: Shiratori
authors.forename: Gen
authors.initials: G
authors.lastname: Yamada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Itoh
authors.forename: Shintaro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Manabu
authors.initials: M
authors.lastname: Nagata
authors.forename: Hitoki
authors.initials: H
authors.lastname: Saizen
authors.forename: Masaaki
authors.initials: M
authors.lastname: Satoh
authors.forename: Shosaku
authors.initials: S
authors.lastname: Abe
mesh_terms: D000199:Actins / Q000276:immunology; D000328:Adult; D000951:Antigens, Neoplasm; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D018192:Lymphangioleiomyomatosis / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D058950:Melanoma-Specific Antigens; D032389:Myocytes, Smooth Muscle / Q000473:pathology; D009363:Neoplasm Proteins / Q000276:immunology; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed
chemical_list: D000199:Actins; D000951:Antigens, Neoplasm; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins