A Pleuro-Peritoneal Communication through the Diaphragm affected with Lymphangioleiomyomatosis
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概要
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A 30-year-old Japanese woman with lymphangioleiomyomatosis (LAM) developed a left chylothorax and chylous ascites. A pleuro-peritoneal communication was confirmed by a scintigram with 99mTc-labeled macroaggregated-albumin injected into the peritoneal cavity. Video-assisted thoracic surgery revealed a protruding papillary lesion on the left diaphragm. Chyle was oozing into the pleural cavity through this lesion. Histopathological analyses demonstrated that the protrusion was a diaphragmatic LAM lesion and that LAM-associated lymphangiogenesis enabled communication between the pleural and peritoneal cavities through lymphatic vessels. This case demonstrated a new mechanism for chylous pleural effusion in LAM and illustrates the significance of LAM-associated lymphangiogenesis.
著者
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Sato Teruhiko
Department Of Respiratory Medicine Juntendo University School Of Medicine
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Seyama Kuniaki
Department Of Respiratory Medicine
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Morio Yoshiteru
Department Of Respiratory Medicine Juntendo University School Of Medicine
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KODAMA Yuzo
Department of Respiratory Medicine
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Mitani Keiko
Department Of Human Pathology Juntendo University School Of Medicine
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TAKAGI Yumiko
Department of Natural Sciences, Hyogo University of Teacher Education
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Takahashi Kazuhisa
Department Of Applied Chemistry Faculty Of Science Science University Of Tokyo
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Miyamoto Hideaki
Department Of Dermatology Hiratsuka Mutual Aid Hospital
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Kumasaka Toshio
Division of Pathology, Japanese Red Cross Medical Center
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Iwakami Shin-ichiro
Division of Respiratory Medicine, Shizuoka Juntendo University Hospital
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Onuma Emi
Department of Respiratory Medicine, Tokyo Metropolitan Koto Geriatric Medical Center
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Sato Teruhiko
Department of Respiratory Medicine, Juntendo University School of Medicine
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Takagi Yumiko
Department of Chemistry, Faculty of Education, Okayama University
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