Rounded atelectasis associated with pulmonary lymphangioleiomyomatosis

Our plain-English summary of Rounded atelectasis associated with pulmonary lymphangioleiomyomatosis, by K. Kishi, S. Homma, A. Miyamoto, et al (Internal Medicine, 2005).

The study

• Authors: K. Kishi, S. Homma, A. Miyamoto, A. Kurosaki, N. Motoi, T. Kohno, K. Yoshimura
• Journal: Internal Medicine
• Published: 2005;44(6):625-7
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Rounded atelectasis is an unusual form of lung collapse that develops as a consequence of pleural diseases. Among a variety of conditions, asbestos inhalation has been attributed in most cases, but many other causes have also been implicated. Here, we describe the first case of rounded atelectasis and pneumothorax associated with pulmonary lymphagioleiomyomatosis.

In plain English

This was a case report from Toranomon Hospital in Tokyo describing one patient. She was a 45-year-old woman with no symptoms and no history of smoking or exposure to asbestos. A screening chest X-ray showed a mass and a collapsed lung (pneumothorax) on the right side. A CT scan found many thin-walled cysts in both lungs, the pneumothorax, a small amount of fluid around the lung, and a 4 by 4 cm rounded mass with scattered calcification touching thickened pleura. The authors judged from an X-ray taken 18 months earlier that the lesion had formed within 18 months. Tissue removed during video-assisted thoracoscopic surgery showed deep folding of the thickened pleura with collapsed lung beneath it, which was compatible with rounded atelectasis. Abnormal smooth muscle cells stained for HMB45. The diagnosis was rounded atelectasis associated with pulmonary lymphangioleiomyomatosis (LAM). The authors assumed that repeated, unnoticed pneumothoraces had inflamed the pleura. They concluded this was the first described case of rounded atelectasis as a complication of LAM. The patient remained well without treatment.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 45-year-old woman, a housewife without symptoms, admitted to Toranomon Hospital, Tokyo, after a screening chest radiograph
• Exposure: No asbestos exposure and no smoking history. The condition linked to the rounded atelectasis was pulmonary lymphangioleiomyomatosis (LAM).
• Main results:
  • CT showed a well-defined rounded mass (4×4 cm) in the superior segment of the right lower lobe, with scattered calcification, next to thickened pleura. It also showed multiple thin-walled cysts in both lungs and a right-sided pneumothorax with a small pleural effusion.
  • A radiograph taken 18 months earlier showed slight pleural thickening but no mass. The authors concluded the rounded atelectasis had formed within 18 months.
  • The resected tissue showed deep folding of the thickened visceral pleura with collapsed lung tissue beside it, compatible with rounded atelectasis.
  • Abnormal smooth muscle cells stained with an antibody against HMB45. The histopathological diagnosis was rounded atelectasis associated with LAM.
  • The authors assumed that recurrent pneumothoraces the patient had not noticed caused pleural inflammation, which led to the rounded atelectasis.
  • The patient remained well after surgery and was under close observation without treatment.
• The authors' conclusion: The authors concluded that, to their knowledge, this was the first description of rounded atelectasis as a complication of LAM or tuberous sclerosis.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Rounded Atelectasis, Pneumothorax.

Related studies

• Rounded atelectasis complicated by obstructive pneumonia and pulmonary arterial thrombosis — C.H. Chen, L. Newman (1990)
• Rounded atelectasis of the lung — G.T. Stathopoulos, M.T. Karamessini, et al. (2005)
• Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases — C. Voisin, F. Fisekci, et al. (1995)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Rounded atelectasis due to acute exudative effusion. Spontaneous resolution — L.S. Smith, R.F. Schillaci (1984)
• Rounded atelectasis and mesothelioma — R.F. Munden, H.I. Libshitz (1998)

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