Tuberous sclerosis is a rare genetic disease with protean clinical 
manifestations. The lesion most commonly described in the lung is 
lymphangiomyomatosis. There have been recent reports of multifocal micronodular 
pneumocyte hyperplasia, as well as a single case documentation of a clear cell 
tumor of the lung, in patients affected by the disease. We detail a case of a 
female Chinese patient with tuberous sclerosis who was incidentally discovered 
to have bilateral pneumothoraces. The open lung biopsy revealed combined 
histological features of multifocal micronodular pneumocyte hyperplasia, 
lymphangiomyomatosis and clear cell micronodules.