Presentation
Shortness of breath.
Patient Data
Bilateral pneumothoraces wiith diffusely increased lung markings.
Left pleural pigtail catheter, trace left pneumothorax. Multiple thin-walled cysts both lungs, fairly uniform in size and distribution. Bibasilar atelectasis, no pleural effusions
Bilateral fat-containing renal tumors, aneurysm inferior pole right kidney with surrounding hematoma and possible active extravasation. Fat-containing liver masses.
Tortuous vessels with multiple small aneurysms. Interval embolization of the right inferior pole aneurysm that was present on the abdominal CT scan.
Multiple bilateral calcified subependymal nodules.
Case Discussion
Characteristic findings of tuberous sclerosis involving the lungs (cysts), liver (hepatic angiomyolipomas), both kidneys (renal angiomyolipomas) and the brain (calcified subependymal hamartomas). All of these abnormalities are associated with complications: 1) lung cysts may rupture and cause a pneumothorax, 2) hepatic angiomyolipomas may bleed, 3) renal angiomyolipomas are hypervascular and form aneurysms and may bleed and 4) subependymal hamartomas may become subependymal giant cell astrocytomas and obstruct the ventricular system, leading to hydrocephalus.
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