To the Editors:
A 69-yr-old post-menopausal female with pulmonary nodules and a diagnosis of lymphangioleiomyomatosis (LAM) confirmed elsewhere was referred to our centre (U.O. di Pneumologia, Ospedale San Giuseppe, Milan, Italy) for further evaluation. The patient was a nonsmoker and denied any occupational exposures. There was no family history of cancer. She had no history of pulmonary diseases or respiratory symptoms. Her past medical history included systemic hypertension treated with angiotensin converting enzyme inhibitor, hypercholesterolemia treated with atorvastatin, and diabetes mellitus. The patient had been well until July 2008 when she was evaluated in another hospital and a breast carcinoma was discovered. Multiple bilateral small nodules of the lung were noted on a chest computed tomography performed at the time of breast carcinoma diagnosis (figs 1 and 2). Fluorodeoxyglucose-positron emission tomography did not disclose pathological uptake of the lung nodules. A wedge resection of the lung was performed. The histological diagnosis was LAM. In October 2008 the patient underwent breast conserving surgery (quadrantectomy) with excision of the lesion in the right breast; the pathological diagnosis was infiltrating ductal carcinoma. She was started on tamoxifen treatment.
Chest computed tomography scan showing multiple, bilateral, well-circumscribed pulmonary nodules.
Another chest computed tomography scan showing multiple, bilateral, well-circumscribed pulmonary nodules.
The patient was evaluated in our department in March 2009. She was completely asymptomatic with no complaints of shortness of breath, cough, chest pain, fever, …
