van Loenhout C J, den Bakker M A, van Wijsenbeek M S, Hoek R A S, van Hal P Th W
Erasmus MC, Rotterdam.
Ned Tijdschr Geneeskd. 2016;160:D757.
Lymphangioleiomyomatosis (LAM) is characterised by progressive dyspnoea, spontaneous pneumothorax and cystic pulmonary destruction. The disease may show similarities with emphysema clinically, radiologically and on lung function tests.
A 44-year-old woman was referred for lung transplantation because of a 6-year history of dyspnoea and severe obstructive pulmonary function disorder with decreased diffusion capacity. Both her relatively young age and the fact that she had never smoked made us doubt the diagnosis 'COPD'. The pulmonary cysts seen on high-resolution CT (HRCT) suggested LAM. This was confirmed when we revised a pulmonary biopsy that had previously been performed.
CT investigation should be carried out in patients with severe obstructive pulmonary disease without a risk profile appropriate for COPD. Diffuse, homogenous cysts on CT scan can indicate LAM, particularly in women. Conflict of interest and financial support: none declared.
淋巴管平滑肌瘤病(LAM)的特征为进行性呼吸困难、自发性气胸和肺部囊性破坏。该疾病在临床、放射学及肺功能检查方面可能与肺气肿表现相似。
一名44岁女性因6年的呼吸困难病史及严重的阻塞性肺功能障碍伴弥散功能下降而被转诊进行肺移植。她相对年轻且从不吸烟这一事实使我们对“慢性阻塞性肺疾病(COPD)”的诊断产生怀疑。高分辨率CT(HRCT)上所见的肺囊肿提示LAM。当我们复查此前进行的肺活检时,这一诊断得到了证实。
对于患有严重阻塞性肺疾病但无符合COPD风险特征的患者,应进行CT检查。CT扫描上弥漫、均匀的囊肿可能提示LAM,尤其是在女性患者中。利益冲突及资金支持:无申报。