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Chylothorax after Excision of The Right Broad Ligament Mass of The Uterus was Diagnosed Lymphangiomyomatosis A Case Report and Literature Review

Author(s): Liwan Dai, Tao Chen, Jinxing Wu

Lymphangioleiomyomatosis (LAM) is a rare disease frequently (often) occurs in women of childbearing age. It is a multi-systemic disorder characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues. We will report a case of a patient diagnosed with LAM who presented with chylothorax after hysterectomy of broad ligament.

Background

Lymphangioleiomyomatosis (LAM) is a rare disease frequently occurs in women of childbearing age. It is a multi-systemic disorder characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues. The exact etiology of this disease is not known, but due to the gender-specific nature of this disease, the female reproductive system is currently considered as the source of this cell. We will report a case of a patient diagnosed with LAM who presented with chylothorax after b road ligament resection. This phenomenon has not been reported in our literature study, which would provide new evidence for the mechanism of the disease.

Case presentation

A woman who was found to be occupying the right broad ligament developed dyspnea after surgical treatment. Chest CT found bilateral pleural effusion and multiple cystic lesions in both lungs. The pleural fluid Chyle test was positive, subsequent postoperative pathology confirmed LAM. The patient was treated by Sirolimus with Ideal therapeutic effect. However the presence of chylothorax after adnexal occupying resection has not been reported.

Conclusions

The pathogenesis of LAM is not completely clear, but the clinical manifestations of this patient seem to confirm the hypothesis that LAM originates from the female reproductive system. LAM should be considered in the differential diagnosis of female reproductive system tumors, we suggested to improve chest CT before surgery to be vigilant against the possibility of LAM if multiple cystic changes occur in pulmonary.

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