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World J Clin Cases. 2019 Jul 26;7(14):1892-1898. doi: 10.12998/wjcc.v7.i14.1892.

Pulmonary Langerhans cell histiocytosis in adults: A case report.

Author information

1
Department of Respiration, People's Hospital of Jingjiang, YangZhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China.
2
Department of Respiration, People's Hospital of Jingjiang, YangZhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China. chenyao760@outlook.com.

Abstract

BACKGROUND:

Langerhans cell histiocytosis (LCH) is a rare disease of unknown aetiology. While it may affect any organ of the body, few cases of solitary lung involvement are published in the literature. Here, we report a rare case of pulmonary LCH (PLCH) in an adult.

CASE SUMMARY:

A 52-year-old male presented to hospital in July 2018 with complaints of progressively worsening cough with sputum, breathlessness, easy fatigability, and loss of appetite since 2016, and a 32-year history of heavy cigarette smoking (average 30 cigarettes/d). Physical examination showed only weakened breathing sounds and wheezing during lung auscultation. Chest computed tomography (CT) showed irregular micronodules and multiple thin-walled small holes. Respiratory function tests showed a slight decrease. Ultrasonic cardiogram showed mild tricuspid regurgitation and no pulmonary hypertension. Fibreoptic bronchoscopy was performed with transbronchial biopsies from the basal segment of right lower lobe. LCH was confirmed by immunohistochemistry. The final diagnosis was PLCH without extra-pulmonary involvement. We suggested smoking cessation treatment. A 3-mo follow-up chest CT scan showed clear absorption of the nodule and thin-walled small holes. The symptoms of cough and phlegm had improved markedly and appetite had improved. There was no obvious dyspnoea.

CONCLUSION:

Imaging manifestations of nodules, cavitating nodules, and thick-walled or thin-walled cysts prompted suspicion of PLCH and lung biopsy for diagnosis.

KEYWORDS:

Adult; Case report; Imaging; Nodules; Pulmonary Langerhans’ cell histiocytosis; Smoking cessation

Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

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