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Key features included bilateral pleural\/pericardial effusions; chest\/abdominal CT showed diffuse mediastinal infiltration, bronchovascular\/interlobular septal thickening, and extrathoracic extension to periaortic abdominal tissues. Definitive diagnosis was confirmed by thoracoscopic biopsy and immunohistochemistry (CD31+, D2-40+, Ki-67\u2009\u2248\u20093%), differentiating it from mimics like pulmonary lymphangiectasia. The patient achieved symptomatic remission after pericardiectomy, thoracic catheter drainage, and postoperative sirolimus. This case enriches pediatric GLA literature, highlights multidisciplinary diagnosis value, and supports mTOR inhibitors\u2019 role in pediatric GLA management.<\/jats:p>","DOI":"10.3389\/fped.2025.1591611","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T06:38:25Z","timestamp":1767595105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Diffuse pulmonary lymphangiomatosis in a 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