Lymphangioleio-myomatosis (LAM) is a relatively rare disease that occurs in almost all cases in women, mainly in the reproductive age group, with an average age of 30-40 years. The incidence of sporadic LAM is about 1 in 1 million of the total population, but in women with the hereditary disease tuberous sclerosis complex (TSC, see the New England Journal of Medicine, September 28, 2006, for a translation of the review), LAM has a high incidence, which can be as high as 40%. In China, LAM was first reported in the literature in the 1980s, and by the end of 2005, more than 100 cases had been reported, 63% of which were reported after 2001. Pleural effusion is another common presentation of LAM, which is usually celiac disease. What is celiac disease? Celiac fluid is a milky white fluid in the lymphatics. Long-chain triglycerides from the diet are transported via the gastrointestinal lymphatics to the celiac pond, where they are converted into celiac particles and very low density lipoproteins, which enter the thoracic cavity via the thoracic duct, travel up the front of the spine, and finally enter the circulation. About 2 liters of celiac fluid are usually produced per day. In the general patient, the causes of celiac disease include surgery, trauma and tuberculosis, etc. In LAM patients, celiac fluid leaks out of the broken lymphatic vessels due to structural defects in the lymphatic vessels. Leakage of celiac fluid into the chest cavity is called celiothorax, leakage of celiac fluid into the abdominal cavity is called celiac ascites, and leakage of celiac fluid into the pericardial cavity is called celiac pericardial effusion. Symptoms and diagnosis of celiac disease? Symptoms of celiac disease can be sudden onset of chest pain and dyspnea, such as chest tightness and shortness of breath, or cough and fever. Chest X-ray can easily detect pleural effusion, and milk-like fluid can be seen by extracting pleural fluid through thoracentesis, and laboratory tests can confirm whether it is indeed celiac disease. How is celiac disease treated? First, in terms of diet, fasting and parenteral nutrition can eliminate the source of celiac fluid and facilitate thoracic duct repair. To laboratory or alleviate the symptoms of dyspnea, the doctor drains the celiac fluid through closed chest drainage. In most patients, celiac leakage can be gradually reduced with symptomatic treatment. If the results are poor, pleural adhesions are considered.