title: Recurrent bilateral spontaneous pneumothorax secondary to lung adenocarcinoma with epidermal growth factor receptor mutation.
abstract: A 42-year-old female patient was admitted for recurrent bilateral spontaneous pneumothorax. High resolution computed tomography showed bilateral pneumothorax and numerous round and oval, thin-walled lung cysts. Microscopically, each small cyst was composed of distended subpleural alveolar spaces. Tumor cells, characteristic of acinar adenocarcinoma, obstructed and narrowed the terminal bronchioles. There was no tumor necrosis or mucin production. This suggested check-valve as a possible mechanism of the thin-walled cysts and pneumothorax. Genetic analysis suggested that the tumors were positive for epidermal growth factor receptor mutation L858R in exon 21. Bilateral spontaneous pneumothorax and thin-walled cysts in association with lung cancer is rarely reported and may be confused with cystic benign lung lesions.
authors.affiliation: Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China.
authors.forename: Wenhui
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China.
authors.forename: Yingxiang
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China.
authors.forename: Yanxia
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Pathology Beijing Chao-Yang Hospital Capital Medical University Beijing China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wei
authors.affiliation: Department of Respiratory and Critical Care Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Beijing Institute of Respiratory Medicine Beijing China.
authors.forename: Huaping
authors.initials: H
authors.lastname: Dai
keywords: Epidermal growth factor receptor; lung cancer; lung cysts; pneumothorax