How to distinguish between pulmonary vesicle and pulmonary lymphangioleiomyomatosis

Pulmonary lymphangioleiomyomatosis, which is very similar to pulmonary vesicles, develops to a later stage, in which collagen is deposited and increased to form nodules, edema, or bleeding in the continuous accumulation of muscle cells, and the destroyed alveoli will merge with each other to form sacs. The shape is very similar to the pulmonary vesicles, when macrophages decrease. If there is no regular physical examination X-ray chest X-ray, respiratory symptoms or serious symptoms, to the hospital examination, sometimes easy to be confused with pulmonary vesicles.

Bullae surgery

In the late stage of pulmonary lymphangioleiomyomatosis, the cyst wall is lined with flat epithelium and ciliated epithelium, and the hyperplastic nodules on the cyst may extend into the cyst, alveoli and bronchioles, resulting in continuous thickening and structural disorder of the cyst wall. When dilated lymphatic vessels form cysts similar to pulmonary vesicles on the muscular and parietal pleura, new atypical smooth muscle cells appear on the lymphatic vessels, bronchovascular bundles and venules.

These short and polymorphic atypical smooth muscle cells are very similar to smooth muscle, also known as clonal smooth muscle in medicine, there is a certain degree of hemosiderin in muscle tissue. In the course of continuous growth, it will go deep into the alveoli and interstitium, resulting in lumen obstruction and dilatation, and the formation of new diffuse terminal dilated cysts with a diameter of 1cm or larger. In the continuous development, pulmonary lymphangioleiomyoma dilated or twisted, so that the venule rupture will cause a small amount of bleeding, patients may cough up blood, or even pneumothorax.

Operation of pulmonary lymphatic leiomyoma

Pulmonary lymphangioleiomyomatosis can easily lead to enlargement of hilar, mediastinal and abdominal posterior wall lymph nodes, thickening and dilatation of thoracic duct, formation of chylothorax after internal obstruction, and even extra-thoracic organ or tissue angiomyomatosis. Such as kidney, abdominal posterior wall, abdominal cavity, pelvic cavity, such as intermittent or simultaneous angiomyomatosis, physical performance of the corresponding organ or tissue-related symptoms. In addition, the associated symptoms of hypertrophic vesicles and pulmonary lymphangioleiomyoma are also different, and it is easier to identify when combined.

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