Those clinical features are: the presence of TSC, renal angiomyolipoma(s), elevated serum VEGF-D ≧800 pg/mL, chylous effusion (pleural or ascites) confirmed by tap and biochemical analysis of the fluid, lymphangioleiomyomas, or demonstration of LAM cell clusters or LAM cells on cytological examination of chylous effusions or aspiration of lymph nodes [8]. Here, VEGFD is linked to tuberous sclerosis.