Taniguchi Yuji, Haruki Tomohiro, Fujioka Shinji, Adachi Yoshin, Miwa Ken, Nakamura Hiroshige
Operating Room Division, Tottori University Hospital, 36-1 Nishi-cho, Yonago, Tottori 683-8504, Japan.
Gen Thorac Cardiovasc Surg. 2008 Feb;56(2):81-4. doi: 10.1007/s11748-007-0194-7. Epub 2008 Feb 24.
We herein describe the case of a 20-year-old woman who was diagnosed as having tuberous sclerosis complex (TSC) at the age of 10 years. The patient had a history of right pneumothorax at the age of 19. This time, a right pneumothorax recurrence was detected, and video-assisted thoracoscopic surgery (VATS) was performed. In the intraoperative findings, an infinitesimal lung cyst was detected on the lung lobe, and partial resection was performed. Pathologically, antibody-positive smooth muscle cells of the human melanoma block (HMB)-45 had grown and been diagnosed as pulmonary lymphangioleiomyomatosis (LAM). About half a year later, left pneumothorax occurred, and VATS was performed again. Pathologically, antibody-positive smooth muscle cells of HMB-45 were not detected. Occasionally, TSC is known to cause LAM complications, but in some cases it is difficult to make an accurate pathological diagnosis. Making a pathological diagnosis based on the VATS findings and taking a sufficient amount of tissue specimen are considered useful for making the diagnosis.
我们在此描述一名20岁女性的病例，该患者10岁时被诊断为结节性硬化症（TSC）。患者19岁时有右气胸病史。此次，检测到右气胸复发，并进行了电视辅助胸腔镜手术（VATS）。术中发现，肺叶上有一个极小的肺囊肿，并进行了部分切除。病理检查显示，人黑色素瘤阻滞（HMB）-45抗体阳性的平滑肌细胞增生，被诊断为肺淋巴管平滑肌瘤病（LAM）。大约半年后，发生了左气胸，并再次进行了VATS。病理检查未检测到HMB-45抗体阳性的平滑肌细胞。众所周知，TSC偶尔会引起LAM并发症，但在某些情况下，很难做出准确的病理诊断。基于VATS检查结果进行病理诊断并采集足够的组织标本被认为有助于诊断。
