SPONTANEOUS PNEUMOMEDIASTINUM REVEALING DIFFUSE CYSTIC LUNG DISEASE IN A YOUNG WOMAN: A CASE SUGGESTIVE OF LYMPHANGIOLEIOMYOMATOSIS

Abstract

Spontaneous pneumomediastinum is a rare clinical entity characterized by the presence of air in the mediastinum without preceding trauma or invasive procedures. It predominantly affects young adults and usually has a benign outcome. We report the case of a 22-year-old woman presenting with sudden retrosternal chest pain and dyspnea, whose chest CT revealed pneumomediastinum associated with cervical and thoracic subcutaneous emphysema. Conservative treatment led to clinical improvement, but follow-up imaging uncovered diffuse bilateral thin walled pulmonary cysts suggestive of lymphangioleiomyomatosis (LAM). Pulmonary function tests showed severe ventilatory impairment, and the patient was referred for specialized care. This case highlights that spontaneous pneumomediastinum may be the first manifestation of underlying cystic lung disease, particularly LAM in young women. Early recognition through imaging and clinical evaluation is crucial for diagnosis and management.