Chen Hong-Bin, Xu Xiao-Hong, Yu Cai-Gui, Wan Meng-Ting, Feng Chuang-Li, Zhao Zhi-Yu, Mei Dan-E, Chen Jin-Ling
Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
Department of Pulmonary and Critical Care Medicine, People's Hospital of Hanchuan, Hanchuan 431600, Hubei Province, China.
World J Clin Cases. 2021 Aug 26;9(24):7085-7091. doi: 10.12998/wjcc.v9.i24.7085.
Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues, which can be associated with tuberous sclerosis complex (TSC). The disorder of TSC has a variable expression, and there is great phenotypic variability.
A 32-year-old Chinese woman with a history of multiple renal angioleiomyolipoma presented with a productive cough persisting for over 2 wk. High-resolution chest computed tomography revealed interstitial changes, multiple pulmonary bullae, bilateral pulmonary nodules, and multiple fat density areas of the inferior mediastinum. Conventional and contrast ultrasonography revealed multiple high echogenic masses of the liver, kidneys, retroperitoneum, and inferior mediastinum. These masses were diagnosed as angiomyolipomas. Pathology through thoracoscopic lung biopsy confirmed LAM. Furthermore, high-throughput genome sequencing of peripheral blood DNA confirmed the presence of a heterozygous mutation, c.1831C>T (p.Arg611Trp), of the gene. The patient was diagnosed with TSC-LAM.
We highlight a rare case of TSC-LAM and the first report of a mediastinum lymphangioleiomyoma associated with TSC-LAM.
淋巴管平滑肌瘤病(LAM)是一种罕见的囊性肺部疾病,其特征是肺和其他组织中平滑肌细胞的增殖、转移和浸润,可与结节性硬化症(TSC)相关。TSC的病症具有可变表达,且存在很大的表型变异性。
一名32岁有多次肾血管平滑肌脂肪瘤病史的中国女性,出现持续2周以上的咳痰。高分辨率胸部计算机断层扫描显示间质改变、多个肺大疱、双侧肺结节以及下纵隔多个脂肪密度区。常规及增强超声检查显示肝脏、肾脏、腹膜后及下纵隔有多个高回声团块。这些团块被诊断为血管平滑肌脂肪瘤。经胸腔镜肺活检的病理检查确诊为LAM。此外,外周血DNA的高通量基因组测序证实该基因存在杂合突变c.1831C>T(p.Arg611Trp)。该患者被诊断为TSC-LAM。
我们重点介绍了一例罕见的TSC-LAM病例,并首次报告了与TSC-LAM相关的纵隔淋巴管平滑肌瘤。