Examples of Small Airway Obstruction in LAM

Normal Airway with Surrounding Cystic Spaces This small airway, with almost no abnormal LAM cells in the wall likely becomes narrowed during expiration by air trapped in the cystic spaces. Note the decreased number of alveolar supports around the airway and the lack of airway inflammatory cells, goblet cells, and luminal exudate.

Airway Narrowed by Proliferating LAM Cells This small airway is completely surrounded by criss-crossing bundles of LAM cells with slit-like vascular channels. Here the proliferating cells narrow the lumen and restrict airflow. Probably both lesions shown here contribute to the airflow obstruction.

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