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Abstract

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Article in Japanese

Case Report

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

ABSTRACT

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.

KEYWORDS

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

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