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Multifocal Micronodular Pneumocyte Hyperplasia: Computed Tomographic Appearance and Follow-Up in Tuberous Sclerosis Complex

Muzykewicz, David A. MD*; Black, Margaux E. BA*; Muse, Victorine MD; Numis, Adam L. MD*; Rajagopal, Jayaraj MD; Thiele, Elizabeth A. MD, PhD*; Sharma, Amita MD

Journal of Computer Assisted Tomography: September/October 2012 - Volume 36 - Issue 5 - p 518–522
doi: 10.1097/RCT.0b013e318264e404
Thoracic Imaging

Objective: To characterize pulmonary nodules in patients with tuberous sclerosis complex (TSC) using computed tomography.

Methods: We retrospectively reviewed chest computed tomographic images of 73 patients with TSC (22 males and 51 females; mean ± SD age, 31.5 ± 13.2 years; range, 13.8–63.5 years).

Results: Multiple pulmonary nodules were identified in 42 (58%) of 73 patients (mean ± SD size, 6.6 ± 3.0 mm; range, 2–14 mm). Solid nodules were present in 11 (26%) of 42 patients, ground-glass nodules were present in 3 (7%) of 42 patients, and both solid and ground-glass nodules were present in 28 (67%) of 42 patients. The presence of multiple nodules was independent of sex and lymphangioleiomyomatosis. Follow-up images were available for 22 patients with multiple nodules (mean ± SD follow-up, 2.0 ± 1.1 years; range, 0.9–4.9 years), none of whom had change in nodule size or number.

Conclusions: Most men and women with TSC have multiple pulmonary nodules, which likely represent multifocal micronodular pneumocyte hyperplasia in the absence of known predisposing factors.

From the Departments of *Neurology and †Radiology, and ‡Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA.

Received for publication April 3, 2012; accepted June 15, 2012.

Reprints: Amita Sharma, MD, Department of Thoracic Imaging, Massachusetts General Hospital, 55 Fruit Street, FND 202, Boston, MA 02114 (e-mail:

This study was supported by the Herscot Center for Tuberous Sclerosis Complex and NIH/NINDS P01 NS024279.

DA Muzykewicz and ME Black contributed equally to this work.

The authors have no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.