title: Two Kinds of Cystic Lung Lesions with Pulmonary Lymphangioleiomyomatosis in a Male.
abstract: A 34-year-old male with frequent recurrence of right pneumothorax was admitted to our hospital. He was a current smoker and outwardly male without genital aplasia. He was diagnosed as tuberous sclerosis complex (TSC) at 2 year-old and underwent transcatheter arterial embolization for right renal hemorrhage due to renal tumor 2 years ago. Chest Computed Tomography showed that he had multiple tiny round cystic lesions with thin wall in both lungs. The recurrent pneumothorax was expected to be associated with TSC-Lymphangioleiomyomatosis (LAM). Video-assisted thoracic surgery was successfully performed. The operative and histological findings revealed that the bullae were classified into two groups; emphysematous bullae and bullae due to LAM. His postoperative course was uneventful. TSC-LAM is extremely rare, but in some cases the clinical recognition might be escaped due to subtle findings of bullae in early LAM, resulting in diagnosis as spontaneous pneumothorax.
authors.affiliation: Nissan Kohseikai Institute of Medicine, Pneumothorax Research Center, Tokyo, Japan.
authors.forename: Sumitaka
authors.initials: S
authors.lastname: Yamanaka
authors.forename: Teruaki
authors.initials: T
authors.lastname: Mizobuchi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kurihara
mesh_terms: D000328:Adult; D001706:Biopsy; D001768:Blister / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D018192:Lymphangioleiomyomatosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D011030:Pneumothorax / Q000209:etiology; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012008:Recurrence; D012907:Smoking / Q000009:adverse effects*; D020775:Thoracic Surgery, Video-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014402:Tuberous Sclerosis / Q000150:complications* / Q000175:diagnosis