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Mental Status Changes. History. 52 y o female presented to the ED with mental status changes Bradycardia noted in ED. Chest Radiograph. Chest CT. History. Lifelong nonsmoker Maternal history of emphysema Smoker Chronic daily cough No hemoptysis SOB with exertion No toxic exposure.

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history
History
  • 52 y o female presented to the ED with mental status changes
  • Bradycardia noted in ED
history1
History
  • Lifelong nonsmoker
  • Maternal history of emphysema
    • Smoker
  • Chronic daily cough
  • No hemoptysis
  • SOB with exertion
  • No toxic exposure
lymphangioleiomyomatosis lam
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 cystic
  • Often misdiagnosed as asthma or COPD
  • Most common presenting symptoms:
    • Dyspnea
    • Pneumothorax

Gross specimen demonstrating cystic changes

lymphangioleiomyomatosis lam1
Lymphangioleiomyomatosis (LAM)
  • Progressive disease, no treatment is curative
  • Median survival is 8-10 years from time of diagnosis
  • Female predominance
    • Usually occurs during the reproductive years
  • Pregnancy and HRT accelerate the disease