Krüger Stefan, Varwerk Claudia, Passlick Bernward, Morresi-Hauf Alicia, Thetter Olaf, Häussinger Karl
Zentrum für Pneumologie und Thoraxchirurgie, Asklepios-Fachkliniken, München-Gauting, Germany.
Med Klin (Munich). 2004 Jan 15;99(1):43-6. doi: 10.1007/s00063-004-1008-7.
Pulmonary lymphangioleiomyomatosis is a rare disease that occurs mainly in women of reproductive age. The clinical characteristics include recurrent spontaneous pneumothorax and progressive dyspnea. The features of chest computed tomography are nearly pathognomonic with the detection of bilateral thin-walled cysts.
A 32-year-old female presented with sudden-onset right-sided chest pain, which aggravated during inspiration, dyspnea at exertion, and cough. She had a history of bilateral recurrent spontaneous pneumothorax. Physical examination showed reduced pulmonary sounds on the right side. Chest X-ray confirmed the diagnosis of recurrent right-sided pneumothorax. Computed tomography showed multiple bilateral bullae. Video-assisted pleurectomy, bulla resection, and bulla coagulation were performed. The diagnosis of pulmonary lymphangioleiomyomatosis was confirmed by pulmonary biopsy. After pleurectomy, the patient remained symptom-free without recurrent pneumothorax.
Pulmonary lymphangioleiomyomatosis is a rare cause of recurrent pneumothorax and should be considered a differential diagnosis, especially in young women with diffuse bilateral bullous emphysema or tuberous sclerosis.
肺淋巴管平滑肌瘤病是一种罕见疾病,主要发生于育龄女性。临床特征包括反复自发性气胸和进行性呼吸困难。胸部计算机断层扫描的特征几乎具有诊断意义,可检测到双侧薄壁囊肿。
一名32岁女性出现突发右侧胸痛,吸气时加重,劳力性呼吸困难和咳嗽。她有双侧反复自发性气胸病史。体格检查显示右侧肺部呼吸音减弱。胸部X线证实复发性右侧气胸的诊断。计算机断层扫描显示双侧多个肺大疱。进行了电视辅助胸膜切除术、肺大疱切除术和肺大疱凝固术。经肺活检确诊为肺淋巴管平滑肌瘤病。胸膜切除术后,患者无症状,未再复发气胸。
肺淋巴管平滑肌瘤病是复发性气胸的罕见病因,应考虑作为鉴别诊断,尤其是对于患有弥漫性双侧肺大疱性肺气肿或结节性硬化症的年轻女性。