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10.5606/tgkdc.dergisi.2013.5722
Bilaterally recurrent spontaneous pneumothorax due to lymphangioleiomyomatosis
Sami Karapolat1, Mesut Erbaş2, Talha Dumlu3, Havva Erdem4, Banu Karapolat5, Selim Erekul6
1Düzce Üniversitesi Tıp Fakültesi, Göğüs Cerrahisi Anabilim Dalı, Düzce, Türkiye
2Düzce Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Düzce, Türkiye
3Düzce Üniversitesi Tıp Fakültesi, Göğüs Hastalıkları Anabilim Dalı, Düzce, Türkiye
4Düzce Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Düzce, Türkiye
5Düzce Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Düzce, Türkiye
6Ankara Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, Ankara, Türkiye
DOI : 10.5606/tgkdc.dergisi.2013.5722
Pulmonary lymphangioleiomyomatosis is an extremely rare
interstitial lung disease. The clinical presentation is generally
recurrent spontaneous pneumothorax and progressive
dyspnea. No definitive treatment option is available and it
leads to respiratory failure due to multicystic destruction
of the lung parenchyma in the following years. A 39-yearold
female patient was admitted to our clinic with the
complaints of sudden onset dyspnea and diffuse chest pain.
Auscultation revealed decreased respiratory sounds in both
lungs. Chest X-ray showed bilateral pneumothorax and
bilaterally tube thoracostomy was performed. Thoracic
tomography demonstrated a few thin-wall cystic structures
in both lungs with a higher number on the right side. We
performed bullectomy, apical wedge resection, apical parietal
pleurectomy and mechanic pleural abrasion on residual pleural
spaces through right posterolateral thoracotomy. One month
later, we performed bullectomy, bulla ligation, apical wedge
resection, apical parietal pleurectomy and mechanic pleural
abrasion on residual pleural spaces through left posterolateral
thoracotomy due to the left recurrent pneumothorax. The
patient was diagnosed with lymphangioleiomyomatosis
based on the histopathological examination. No recurrent
pneumothorax was observed at the end of the two-year followup
period. Lymphangioleiomyomatosis should be kept in
mind in premenopausal women who have bilaterally recurrent
spontaneous pneumothorax. Early surgical treatment should
be planned in these patients due to multiple pneumothorax
recurrences with conservative procedures.
Keywords : Lymphangioleiomyomatosis; pneumothorax; thoracic surgery; tomography
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