School ager with shortness of breath CXR PA (above left) shows large bilateral pleural effusions. Axial CT with contrast of the chest (above right) shows the pleural effusions to be septated. The lung parenchyma (middle) was normal while the bones (below) had multiple cystic bone lesions in the right scapula, vertebral bodies and bilateral ribs. The diagnosis was lymphangioleiomyomatosis with bilateral chylous effusions.