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