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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.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.