Presentation
Follow up of pneumothorax treated with pleural pigtail drain. Recurrent pneumothorax on a background of lymphangioleiomyomatosis and tuberous sclerosis.
Patient Data
Left-sided pigtail drain noted. Diffuse bilateral reticular interstitial pattern and cystic lucencies are consistent with the known history of lymphangioleiomyomatosis. No residual pneumothorax detected. Blunting of the costophrenic angles most likely related to pleural thickening. The cardiothoracic ratio within normal limits. Mediastinal contours are unremarkable. No bony abnormality.
Background cystic lung disease in keeping with the history of lymphangioleiomyomatosis (LAM). A left anterior intercostal pigtail catheter is positioned in the left pleural space anteriorly. Small residual pneumothorax within the left lateral costophrenic angle.
The previously demonstrated 16 mm nodule within the left upper lobe remains similar in size and morphology to the previous examination from one year prior. Stable left-sided pleural thickening is also again noted.
No destructive bony abnormality identified. Innumerable renal angiomyolipomas
also again noted in keeping with the history of tuberous sclerosis (TS).
Impression
tiny residual pneumothorax within the left costophrenic angle. The pleural catheter is well positioned
background changes of LAM and TS noted
Case Discussion
This case demonstrates the classic CXR and CT appearances of lymphangioleiomyomatosis, which in this patient was associated with tuberous sclerosis.
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