Tuberous sclerosis diagnosed by incidental computed tomography findings of multifocal micronodular pneumocyte hyperplasia

A case report

Makoto Ishii, Koichiro Asano, Nobufumi Kamiishi, Yuichiro Hayashi, Daisuke Arai, Mizuha Haraguchi, Hiroaki Sugiura, Katsuhiko Naoki, Sadatomo Tasaka, Kenzo Soejima, Koichi Sayama, Tomoko Betsuyaku

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction. The majority of multifocal micronodular pneumocyte hyperplasia associated with tuberous sclerosis complex is diagnosed with the classical clinical triad of seizures, mental retardation, and skin lesions. We report a rare case of tuberous sclerosis complex with no classical clinical findings, which was diagnosed through incidental computed tomography findings of multiple nodular lesions of multifocal micronodular pneumocyte hyperplasia. Case presentation. A chest computed tomography scan of a 51-year-old Japanese woman showed multiple nodular ground-glass opacities that were not seen on chest X-ray. Video-assisted thoracoscopic surgery was performed. A histological examination demonstrated type II pneumocyte hyperplasia with thickened fibrotic alveolar septa, which was consistent with multifocal micronodular pneumocyte hyperplasia. Brain magnetic resonance imaging displayed multiple cortical tubers, and abdominal computed tomography showed bilateral renal angiomyolipoma. Our patient was finally diagnosed as having tuberous sclerosis complex with multifocal micronodular pneumocyte hyperplasia, although she had no episodes of epilepsy, no skin lesions, and no family history. Conclusions: Multifocal micronodular pneumocyte hyperplasia with latent tuberous sclerosis complex should be considered in the differential diagnosis of multiple ground-glass opacities.

Original languageEnglish
Article number352
JournalJournal of Medical Case Reports
Volume6
DOIs
Publication statusPublished - 2012

Fingerprint

Alveolar Epithelial Cells
Tuberous Sclerosis
Hyperplasia
Tomography
Glass
Thorax
Angiomyolipoma
Video-Assisted Thoracic Surgery
Skin
Intellectual Disability
Epilepsy
Seizures
Differential Diagnosis
Magnetic Resonance Imaging
X-Rays
Kidney
Brain

Keywords

  • Computed tomography (CT)
  • Multifocal micronodular pneumocyte hyperplasia (MMPH)
  • Tuberous sclerosis.

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tuberous sclerosis diagnosed by incidental computed tomography findings of multifocal micronodular pneumocyte hyperplasia : A case report. / Ishii, Makoto; Asano, Koichiro; Kamiishi, Nobufumi; Hayashi, Yuichiro; Arai, Daisuke; Haraguchi, Mizuha; Sugiura, Hiroaki; Naoki, Katsuhiko; Tasaka, Sadatomo; Soejima, Kenzo; Sayama, Koichi; Betsuyaku, Tomoko.

In: Journal of Medical Case Reports, Vol. 6, 352, 2012.

Research output: Contribution to journalArticle

Ishii, Makoto ; Asano, Koichiro ; Kamiishi, Nobufumi ; Hayashi, Yuichiro ; Arai, Daisuke ; Haraguchi, Mizuha ; Sugiura, Hiroaki ; Naoki, Katsuhiko ; Tasaka, Sadatomo ; Soejima, Kenzo ; Sayama, Koichi ; Betsuyaku, Tomoko. / Tuberous sclerosis diagnosed by incidental computed tomography findings of multifocal micronodular pneumocyte hyperplasia : A case report. In: Journal of Medical Case Reports. 2012 ; Vol. 6.
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abstract = "Introduction. The majority of multifocal micronodular pneumocyte hyperplasia associated with tuberous sclerosis complex is diagnosed with the classical clinical triad of seizures, mental retardation, and skin lesions. We report a rare case of tuberous sclerosis complex with no classical clinical findings, which was diagnosed through incidental computed tomography findings of multiple nodular lesions of multifocal micronodular pneumocyte hyperplasia. Case presentation. A chest computed tomography scan of a 51-year-old Japanese woman showed multiple nodular ground-glass opacities that were not seen on chest X-ray. Video-assisted thoracoscopic surgery was performed. A histological examination demonstrated type II pneumocyte hyperplasia with thickened fibrotic alveolar septa, which was consistent with multifocal micronodular pneumocyte hyperplasia. Brain magnetic resonance imaging displayed multiple cortical tubers, and abdominal computed tomography showed bilateral renal angiomyolipoma. Our patient was finally diagnosed as having tuberous sclerosis complex with multifocal micronodular pneumocyte hyperplasia, although she had no episodes of epilepsy, no skin lesions, and no family history. Conclusions: Multifocal micronodular pneumocyte hyperplasia with latent tuberous sclerosis complex should be considered in the differential diagnosis of multiple ground-glass opacities.",
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