Young adult with progressive shortness of breath and adenoma sebaceum, seizures, and mental retardation

CXR and CT of lymphangioleiomyomatosis in a patient with tuberous sclerosis
CXR PA (above) shows bilateral basilar interstitial infiltrates with variably sized cystic spaces. Axial CT without contrast of the right lung (below left) shows a prominent reticular interstitial pattern with fibrosis and widely distributed thin walled cystic spaces. In the left lung (below right), there are similar findings along with a loculated pneumothorax that had been treated with sclerotherapy in the past.

The diagnosis was lymphangioleiomyomatosis in a patient with tuberous sclerosis.