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Linfangioleiomiomatosis pulmonar incidental en una paciente con cáncer de mama
Incidental pulmonary lymphangioleiomyomatosis in a patient with breast cancer
Luis Gorospe Sarasúa
, Ana María Ayala-Carbonero, María Ángeles Fernández-Méndez
Corresponding author
Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, España
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Nótese el aspecto radiológico normal del parénquima pulmonar interpuesto entre los quistes. B) Reconstrucción minIP (proyección de intensidad mínima) axial de la TC de tórax (ventana de parénquima pulmonar) en la que se observan múltiples quistes en ambos pulmones (flechas). C) Imagen axial de la TC de abdomen en la que se identifica una masa (asterisco negro) en el riñón derecho (RD) con un foco de densidad grasa (asterisco blanco), compatible con un angiomiolipoma.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Presentamos el caso de una paciente de 56 años, no fumadora, recién diagnosticada de un cáncer de mama a la que se realizó una TC de tórax y abdomen como parte del estudio de extensión tumoral. En la TC se detectaron inesperadamente múltiples quistes pulmonares con una pared fina bien definida (<a class="elsevierStyleCrossRef" href="#fig0005">figs. 1</a>A y B) y una masa renal derecha con focos de atenuación grasa en su interior (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>C) diagnóstica de un angiomiolipoma (AML). El parénquima pulmonar interpuesto entre los quistes pulmonares era rigurosamente normal. Ante estos hallazgos, se emitió el diagnóstico de linfangioleiomiomatosis pulmonar (LAMP).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La LAMP es una rara enfermedad sistémica que afecta preferentemente a mujeres en edad fértil, caracterizada por la proliferación intersticial de músculo liso anormal que puede obstruir vénulas, vasos linfáticos o bronquiolos, afectando especialmente al pulmón, riñón y bazo, y pudiendo condicionar la aparición de adenopatías, linfangioleiomiomas o colecciones quilosas en la cavidad abdominal. La LAMP puede ser esporádica o asociarse al complejo esclerosis tuberosa (CET), y muchos autores la consideran una forma frustrada de CET. Recientemente se ha demostrado que existen formas leves o subclínicas de LAMP en algunas mujeres con AML, y que el cáncer de mama presenta una incidencia mayor en las pacientes con LAMP<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2319 "Ancho" => 3278 "Tamanyo" => 554387 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Imagen axial de la TC de tórax (ventana de parénquima pulmonar) en la que se aprecian múltiples quistes en ambos pulmones (flechas). Nótese el aspecto radiológico normal del parénquima pulmonar interpuesto entre los quistes. B) Reconstrucción minIP (proyección de intensidad mínima) axial de la TC de tórax (ventana de parénquima pulmonar) en la que se observan múltiples quistes en ambos pulmones (flechas). C) Imagen axial de la TC de abdomen en la que se identifica una masa (asterisco negro) en el riñón derecho (RD) con un foco de densidad grasa (asterisco blanco), compatible con un angiomiolipoma.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frequency of undiagnosed cystic lung disease in patients with sporadic renal angiomyolipomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.H. Ryu" 1 => "T.E. Hartman" 2 => "V.E. Torres" 3 => "P.A. Decker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.11-0669" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2012" "volumen" => "141" "paginaInicial" => "163" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21737494" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Study of breast cancer incidence in patients of lymphangioleiomyomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. Nuñez" 1 => "A. Román" 2 => "S.R. Johnson" 3 => "Y. Inoue" 4 => "M. Hirose" 5 => "Á. Casanova" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10549-016-3737-8" "Revista" => array:6 [ "tituloSerie" => "Breast Cancer Res Treat" "fecha" => "2016" "volumen" => "156" "paginaInicial" => "195" "paginaFinal" => "201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26951504" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000003/v4_201705130114/S030028961630062X/v4_201705130114/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005300000003/v4_201705130114/S030028961630062X/v4_201705130114/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961630062X?idApp=UINPBA00003Z" ]
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