PMC6277247_01
Chest X-Ray without significant findings. Normal lung architecture.
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Initial chest x-ray was normal (Fig. 1).
HCRT of the chest showing bilateral thin-walled numerous cysts (white arrows) which are scattered throughout the lungs with bleb formation (red arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Tomography (HRCT) of the chest revealed numerous small cystic spaces bilaterally with diffuse distribution pattern (Fig. 2). There was mild septal thickening between the cyst spaces with no signs of pleural effusion, bronchiectatic or emphysematous changes.
For H&E. H&E Stain of lung pathology showing plump of spindle-shaped lesional cells from nodules in walls of cystic air spaces. High Magnification of the previous specimen showing spindle-shaped myoid cells in the lung parenchymal wall.
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The specimens showed cyclically dilated air spaces with irregular proliferation of smooth muscle cells (Fig. 3).
For Immunohistochemical Staining. Lesional cells nuclear stain is focally positive for estrogen receptors. Immunohistochemical stain for smooth muscle myosin is positive in lesional cells. Positive immunohistochemically stain for HMB45.
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Immunostaining was positive for lesional smooth muscle cells, actin, desmin and focal positive estrogen and progesterone receptors with Ki-67 proliferation index were 5% (Fig. 4).