title: A pleuro-peritoneal communication through the diaphragm affected with lymphangioleiomyomatosis.
abstract: A 30-year-old Japanese woman with lymphangioleiomyomatosis (LAM) developed a left chylothorax and chylous ascites. A pleuro-peritoneal communication was confirmed by a scintigram with (99)mTc-labeled macroaggregated-albumin injected into the peritoneal cavity. Video-assisted thoracic surgery revealed a protruding papillary lesion on the left diaphragm. Chyle was oozing into the pleural cavity through this lesion. Histopathological analyses demonstrated that the protrusion was a diaphragmatic LAM lesion and that LAM-associated lymphangiogenesis enabled communication between the pleural and peritoneal cavities through lymphatic vessels. This case demonstrated a new mechanism for chylous pleural effusion in LAM and illustrates the significance of LAM-associated lymphangiogenesis.
authors.affiliation: Department of Respiratory Medicine, Juntendo University School of Medicine, Tokyo.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Takagi
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Sato
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Morio
authors.forename: Toshio
authors.initials: T
authors.lastname: Kumasaka
authors.forename: Keiko
authors.initials: K
authors.lastname: Mitani
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Iwakami
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Kodama
authors.forename: Emi
authors.initials: E
authors.lastname: Onuma
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Seyama
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D002916:Chylothorax / Q000209:etiology; D002915:Chylous Ascites / Q000209:etiology; D003964:Diaphragm; D005260:Female; D006801:Humans; D018192:Lymphangioleiomyomatosis / Q000150:complications* / Q000601:surgery; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology; D019042:Muscle Neoplasms / Q000150:complications* / Q000601:surgery; D010529:Peritoneal Cavity / Q000000981:diagnostic imaging / Q000503:physiopathology*; D035422:Pleural Cavity / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011877:Radionuclide Imaging