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Mental Status Changes
History52 y o female presented to the
ED with mental status changesBradycardia noted in ED
Chest Radiograph
Chest CT
HistoryLifelong nonsmokerMaternal history of emphysema
◦SmokerChronic daily coughNo hemoptysisSOB with exertionNo toxic exposure
Lymphangioleiomyomatosis (LAM)Proliferation of pulmonary interstitial smooth
muscle and cyst formation◦ Infiltration into lung parenchyma, lymphatics,
airways and blood vessels
Lungs are large and diffusely cysticOften misdiagnosed as asthma or COPDMost common presenting symptoms:
◦ Dyspnea◦ Pneumothorax
Gross specimen demonstrating cystic changes
Lymphangioleiomyomatosis (LAM)Progressive disease, no
treatment is curativeMedian survival is 8-10 years
from time of diagnosisFemale predominance
◦Usually occurs during the reproductive years
Pregnancy and HRT accelerate the disease