Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7085
Peer-review started: April 29, 2021
First decision: May 23, 2021
Revised: May 30, 2021
Accepted: July 2, 2021
Article in press: July 2, 2021
Published online: August 26, 2021
Processing time: 116 Days and 11.5 Hours
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 TSC2 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.
Core Tip: Lymphangioleiomyomatosis is a rare cystic lung disease that 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 since the age of 14 was diagnosed with TSC-lymphangioleiomyomatosis by high-resolution computed tomography, conventional and contrast ultrasonography, pathology through thoracoscopic lung biopsy, and high-throughput genome sequencing of peripheral blood DNA.