Yano Toshiaki, Hasizume Ikko, Kasamatsu Norio, Kato Toshiya, Shibata Masahiko, Ashinuma Norihiro, Kobayashi Ken, Yasuda Tadashi, Nakamura Akira
Department of Respiratory Medicine, Hamamatsu Medical Center.
Nihon Kokyuki Gakkai Zasshi. 2007 May;45(5):399-403.
We report a case of lymphangioleiomyomatosis, complaining initially of abdominal distension due to massive chylous ascites. The patient was a 28-year-old woman in whom abdominal ultrasound had strongly suggested the existence of both pelvic lymphadenopathy and massive ascites, the latter subsequently turning out to be chylous. Pelvic lymph node biopsy yielded a diagnosis of lymphangioleiomyomatosis. High-resolution computed tomography (HRCT) of the chest showed no remarkable findings except for very few cystic changes in the lung parenchyma. Pulmonary function had remained normal except for a temporary constrictive pattern when chylous pleural effusion developed. No airflow obstruction was detected on pulmonary function tests. Although lymphangioleiomyomatosis is often associated with pulmonary symptoms, we should bear in mind the possibility of lymphangioleiomyomatosis even in the absence of such symptoms when facing any woman of child-bearing age with abdominal chylous ascites of unknown etiology.
我们报告一例淋巴管平滑肌瘤病患者,最初因大量乳糜性腹水而主诉腹胀。患者为一名28岁女性,腹部超声强烈提示盆腔淋巴结肿大和大量腹水,后者随后被证实为乳糜性。盆腔淋巴结活检确诊为淋巴管平滑肌瘤病。胸部高分辨率计算机断层扫描(HRCT)显示除肺实质有极少囊性改变外无明显异常。除乳糜性胸腔积液出现时出现短暂的限制性模式外,肺功能一直正常。肺功能测试未检测到气流阻塞。尽管淋巴管平滑肌瘤病常伴有肺部症状,但当面对任何病因不明的育龄期女性出现腹部乳糜性腹水时,即使没有此类症状,我们也应牢记淋巴管平滑肌瘤病的可能性。