Volume 142, Issue 3, Pages (September 2012)

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Volume 142, Issue 3, Pages 791-796 (September 2012) A 29-Year-Old Woman With an Intractable Postoperative Pleural Effusion and Pulmonary Parenchymal Opacification Hong Ki Min, MD, Jung Im Jung, MD, PhD, Joon Seon Song, MD, Chan Kwon Park, MD, Young Kyoon Kim, MD, PhD, Ji Young Kang, MD CHEST Volume 142, Issue 3, Pages 791-796 (September 2012) DOI: 10.1378/chest.11-1913 Copyright © 2012 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest posteroanterior radiograph shows coarse reticular opacities and multiple cystic changes with ill-defined parenchymal opacification in both lower lung field and a left side pneumothorax. CHEST 2012 142, 791-796DOI: (10.1378/chest.11-1913) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

Figure 2 A, Axial chest CT scan with lung window settings demonstrates multiple small cysts with thin walls in both lungs, ill-defined ground-glass attenuation in intervening parenchyma of both lower lobes, and left-side pneumothorax. B, Thoracic duct dilatation is suspected behind the descending aorta (arrow). Pleural effusion is absent. C, Coronal reformatted image with lung window setting shows the parenchymal lesions with vertical distribution. CHEST 2012 142, 791-796DOI: (10.1378/chest.11-1913) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

Figure 3 A, Follow-up chest radiograph. One week after first chest tube drainage removal, it shows interval increase of left pleural effusion with marked opacification of right lung parenchyme. B, The day after second chest tube drainage insertion, it shows improvement of pulmonary opacification as well as pleural effusion. CHEST 2012 142, 791-796DOI: (10.1378/chest.11-1913) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

Figure 4 A, Lung biopsy displayed smooth muscle-like cells surrounding multiple cysts (hematoxylin and eosin, original magnification ×100). B, The smooth muscle-like cells shows immune positivity for human melanoma black-45 (immunohistochemical stain, original magnification ×200). CHEST 2012 142, 791-796DOI: (10.1378/chest.11-1913) Copyright © 2012 The American College of Chest Physicians Terms and Conditions