Recurrent spontaneous pneumothorax as a clinical presentation of lymphoid interstitial pneumonia: case report

Introduction: Lymphoid interstitial pneumonia (LIP) is a rare pulmonary condition that affects the lung interstitial tissue, frequently associated with autoimmune diseases and viral infections. Case report: We report the case of a 40-year-old woman diagnosed with spontaneous pneumothorax through imaging studies after presenting suggestive symptoms. She was initially treated with a low-caliber pleural catheter but developed four additional spontaneous pneumothoraces over the next 6 months. These were managed again with a low-caliber pleural catheter, chemical pleurodesis, and, as a final measure, a 28 Fr pleural tube. Computed tomography revealed multiple pulmonary cysts, prompting a biopsy due to an initial suspicion of lymphangioleiomyomatosis. Although empirical treatment was initiated, the biopsy showed findings consistent with LIP, leading to an adjustment in management. The patient is currently showing good clinical progress. This case describes a patient without apparent risk factors presenting with a rare disease and an unusual clinical manifestation for LIP. These features may complicate the differential diagnosis of pulmonary pathologies during the initial evaluation. Conclusion: This report aims to contribute additional knowledge about this disease, highlighting the importance of considering uncommon diagnoses in atypical clinical cases.