A case of pulmonary Langerhans cell histiocytosis with difficult diagnosis resulting from atypical radiographic findings
Naoki Arai Mizu Nonaka Takeshi Numata Kyoko Ota Hidetoshi Yanai Takeo Endo
Department of Respiratory Medicine, National Hospital Organization, Mito Medical Center
A 65-year-old man who had smoked 45 packs of cigarettes per year consulted a doctor for treatment of cough. Chest computed tomography (CT) revealed multiple nodular shadows in both lungs. We performed positron emission tomography CT (PET-CT) because of a suspected malignant tumor. Furthermore, a transbronchial lung biopsy was performed, but a diagnosis could not be made. Therefore video-assisted thoracoscopic surgery was performed to aid a definitive diagnosis. The histopathological features of the biopsy sample were consistent with pulmonary Langerhans cell histiocytosis. Distinct cystic changes were not observed on the chest CT, which was an atypical finding for a case of pulmonary Langerhans cell histiocytosis. Therefore, pulmonary Langerhans cell histiocytosis should be considered in the differential diagnosis of multiple nodular shadows.
Pulmonary Langerhans cell histiocytosis Multiple nodular shadow Smoking Bronchoalveolar lavage fluid (BALF)
Received 21 Jun 2016 / Accepted 24 Nov 2016
AJRS, 6(2): 58-62, 2017