title: [Lymphangioleiomyomatosis].
abstract: Lymphangioleiomyomatosis (LAM) is a progressive and usually fatal interstitial lung disease characterized by an abnormal smooth-muscle proliferation in the lung and axial lymphatics. It affects almost exclusively young women of childbearing age. The presenting features most commonly include dyspnea, symptoms of pneumothorax and cough. Less commonly patients can present with chest pain, pleural or pericardial effusion and lymphedema. Our patient, a 41-year-old woman, complained mainly of fatigue that had lasted for 2 months and finally became febrile and dispneic, especially when lying down. Pulmonary diagnostic procedures revealed several multicystic destruction of lung parenchyma. There was also respiratory insufficiency with O2 saturation of 87% and lung diffusion capacity reduced to 48%. The retroperitoneum was filled with neoplastic mass as shown on an abdominal CT scan. Pathohistologic analysis of retroperitoneal mass together with the radiologic finding of the lungs correlated with the diagnosis of LAM. The patient was prescribed corticosteroid therapy, which led to rapid clinical improvement. After making a definite diagnosis, the patient was recommended further treatment with medroxyprogesterone. This case shows that LAM, although rare, can present a diagnostic problem to clinicians and should always be considered as one of the diagnostic possibilities in young women with nonspecific pulmonary symptoms.
authors.affiliation: Odjel za klinicku imunologiju, pulmologiju i reumatologiju, Opća bolnica Sveti Duh, Zagreb, Hrvatska. astipic@mef.hr
authors.forename: Asja
authors.initials: A
authors.lastname: Stipić Marković
authors.forename: Petar
authors.initials: P
authors.lastname: Pekić
authors.forename: Branko
authors.initials: B
authors.lastname: Pevec
authors.forename: Dijana
authors.initials: D
authors.lastname: Rudan
authors.forename: Slobodanka
authors.initials: S
authors.lastname: Ostojić
authors.forename: Sonja
authors.initials: S
authors.lastname: Dzebro
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D018192:Lymphangioleiomyomatosis / Q000175:diagnosis*; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis*