Probable initial pulmonary lymphangioleiomyomatosis and mediastinal lymphangioleiomyoma [Linfangioleiomiomatose pulmonar inicial provável e linfangioleiomioma mediastínico]

A 68 year old woman was submitted to a mediastinal lymphangioleiomyoma resection found in a follow-up study of lower left lung resection due to bronchiectasis complicated by chylothorax. this led to a revaluation of the pulmonary specimen that revealed,in addition to inflammatory bronchiectasis,small spindle cell nodules in the lung parenchyma,similar to minute pulmonary meningothelial-like nodules,but with smooth muscle actin immunohistochemical positivity. the possibility of initial pulmonary development of lymphangioleiomyomatosis is discussed. © 2012 sociedade portuguesa de pneumologia.published by elsevier españa,s.l. all rightsreserved.