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Weekly Chest CasesArchive of Old Cases

Case No : 1050 Date 2017-12-11

  • Courtesy of Soo Hyun Kim, MD, Yun-Hyeon Kim, MD / Chonnam National University Hospital
  • Age/Sex 39 / M
  • Chief ComplaintFurther evaluation of renal mass
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6

Diagnosis With Brief Discussion

Diagnosis
Multifocal micronodular pneumocyte hyperplasia in tuberous sclerosis
Radiologic Findings
Figs 1-5. Chest CT scan with lung window setting shows multiple small solid and ground glass opacity nodules in both lungs.
Brief Review
Multifocal micronodular pneumocyte hyperplasia (MMPH) is a rare pulmonary disorder that can be associated with tuberous sclerosis complex. MMPH can occur in patients with or without lymphangioleiomyomatosis (LAM), predominantly in female patients. At CT, multiple tiny nodular opacities (1~8 mm in diameter) are diffusely scattered throughout the lungs in a random distribution. Although differentiation of MMPH from other diseases with nodular opacities is difficult, MMPH should be considered in the differential diagnosis when multiple tiny pulmonary nodules are present in patients with tuberous sclerosis.
Please refer to
Case 979, Case ,
References
1. Franz DN, Brody A, Meyer C, et al. Mutational and radiographic analysis of pulmonary disease consistent with lymphangioleiomyomatosis and micronodular pneumocyte hyperplasia in women with tuberous sclerosis. Am J Respir Crit Care Med 2001; 164:661-668.

2. Ristagno RL, Biddinger PW, Pina EM, Meyer CA. Multifocal micronodular pneumocyte hyperplasia in tuberous sclerosis. AJR Am J Roentgenol 2005; 184:S37-39.

3. Adriaensen ME, Schaefer-Prokop CM, Duyndam DA, Zonnenberg BA, Prokop M. Fatty foci in the myocardium in patients with tuberous sclerosis complex: common finding at CT. Radiology 2009; 253:359-363.
Keywords
Lung, Kidney, Lung, Others,

No. of Applicants : 82

▶ Correct Answer : 51/82,  62.2%
  • - Ishikawa Matto Central Hospital , Japan MANABU AKIMOTO
  • - Hyogo Prefectural Amagasaki General Medical Center , Japan TOMOAKI OTANI
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Higashi-Ohmi General Medical Center , Japan AKITOSHI INOUE
  • - King Abdulaziz University Hospital , Saudi Arabia Amr M. Ajlan
  • - CH de la Cote Basque , France PAUL ARDILOUZE
  • - , Korea (South) HANKYUL KIM
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) HAYEON LEE
  • - Asan Medical Center , Korea (South) HYUN JUNG KOO
  • - Freelance resident in Reunion Island , Reunion Fabien HO
  • - 罹…stanbul , Turkey AYHAN YILMAZ
  • - Amagasaki General Medical Center , Japan GENKI FUKUMOTO
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - The Jikei university , Japan TAKU GOMI
  • - Qatif Central Hospital , Saudi Arabia HANI MAKKY ALSALAM
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Ajou University Hospital , Korea (South) Taeyang Ha
  • - Seoul National University Hospital , Korea (South) HYOUNG IN CHOI
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Chonnam National University Hospital , Korea (South) JONG HYEON KIM
  • - Seoul National University Hospital , Korea (South) JI EUN KIM
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Dong-A University, College of Medicine , Korea (South) KI-NAM LEE
  • - Samsung Medical Center , Korea (South) KYOWON GU
  • - 怨„紐… , Korea (South) jin young kim
  • - Mallinckrodt Institute of Radiology , United States Naganathan BS Mani
  • - CLINIQUE STE CLOTILDE , Reunion PATRICK MASCAREL
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - Other , Korea (South) SEONGSU KANG
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - University of Florence , Italy MARIAELENA OCCHIPINTI
  • - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - Multimagem Diagn泥˜sticos , Brazil PEDRO PAULO TEIXEIRA E SILVA TORRES
  • - SRMC , India PRABHU RADHAN RADHAKRISHNAN
  • - The University of Tokyo Hospital , Japan TAKU TAJIMA
  • - Yujin Yamazaki Hospital , Japan MASASHI TAKAHASHI
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - Teikyo University Hospital , Japan KAORU SUMIDA
  • - Kyoto Prefectural University of Medicine , Japan TADASHI TANAKA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Private sector , Greece VASILIOS TZILAS
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Kyemyung University Dongsan Hospital , Korea (South) DONG HYEON KIM
  • - Ajou University Hospital , Korea (South) YONG HO JANG
  • - Ewha Womans University Hospital , Korea (South) YOOKYUNG KIM
  • - Samsung Medical Center , Korea (South) HYUN JUNG YOON
▶ Correct Answer as Differential Diagnosis : 3/82,  3.7%
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
  • - University of Utah , United States AKIHIKO SAKATA
▶ Semi-Correct Answer : 5/82,  6.1%
  • - The University of Tokyo Hospital , Japan Yusuke Watanabe
  • - privato , Italy VINCENZO ENZO GENCHI
  • - Escola Paulista de Medicina , Brazil RENATO MASSON DE ALMEIDA PRADO
  • - District TB centre, kasaragod,India , India rikhy krishnan
  • - Fortis hospital , Mohali , India SHALEEN RANA
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