SUCCESSFUL DIAGNOSIS OF LYMPHANGIOLEIOMYOMATOSIS WITH TRANSBRONCHIAL LUNG CRYOBIOPSY

N Gupta, KA Wikenheiser-Brokamp, DS Zander, R Balestra, A Selvaraju, K Niehaus, S Benzaquen

Abstract


A 47-year old female was evaluated in
our clinic for an incidental discovery of
diffuse cystic lung disease on high-resolution
computed tomography (CT) scan of the chest.
There was no personal or family history of
tuberous sclerosis complex (TSC), sicca
symptoms, pneumothorax, or skin or renal
tumors. Review of her chest CT scan showed
bilateral, round, uniform, thin-walled cysts
present in a diffuse distribution characteristic
of lymphangioleiomyomatosis (LAM). CT
scan of the abdomen and pelvis did not reveal
angiomyolipomas, lymphangioleiomyomas,
abnormal lymphadenopathy, or chylous fluid
collections. Serum vascular endothelial growth
factor-D was non-diagnostic. In order to
achieve diagnostic confirmation, the patient
underwent transbronchial cryobiopsy of the
lung, revealing changes consistent with LAM.
Our case highlights the utility of transbronchial
lung cryobiopsy in the evaluation of
patients with suspected LAM and suggests
that further investigation of this diagnostic
technique is warranted in patients presenting
with diffuse cystic lung disease


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