肺朗格汉斯细胞组织细胞增多症的诊断挑战：1例成人结节表现

IF 0.7 Q4 RESPIRATORY SYSTEM

Respiratory Medicine Case Reports Pub Date : 2025-01-01 DOI:10.1016/j.rmcr.2025.102245

Nouman Aziz , Waseem Nabi , Sukhrob Makhkamov , Sadhna Kumari , Dimitri Chepkunov , Daye Chung , Sonu Sahni

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引用次数: 0

摘要

成人肺朗格汉斯细胞组织细胞增生症（PLCH）是LCH的一个鲜为人知的亚群，主要涉及年轻至中年吸烟者，约占成人弥漫性肺病的3 - 5%。本病例报告罕见的成人PLCH伴结节性肺病变，患者为40岁女性，有哮喘、系统性红斑狼疮（SLE）和吸烟史。胸部CT证实双侧多发肺结节，最大可达12毫米。肺结节活检示朗格汉斯细胞浸润，CD1a和S100免疫组化染色阳性，确诊为PLCH。该报告强调了在肺结节鉴别诊断中考虑PLCH的重要性，特别是在有明显吸烟史的患者中，并有助于增加关于成人LCH不同表现的知识体系。

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Diagnostic challenges in pulmonary Langerhans cell histiocytosis: A case report of nodular presentation in an adult

Adult pulmonary Langerhans cell histiocytosis (PLCH) represents a poorly understood subset of LCH, primarily involving young to middle-aged smokers and accounting for approximately 3–5 % of adult diffuse lung diseases. This case report presents uncommon presentation of adult PLCH with nodular pulmonary lesions on a 40-year-old female with a history of asthma, systemic lupus erythematosus (SLE), and smoking. CT chest confirmed multiple bilateral pulmonary nodules, with the largest measuring up to 12 mm. Biopsy of the lung nodules demonstrated Langerhans cell infiltration, with immunohistochemical staining positive for CD1a and S100, confirming the diagnosis of PLCH. The report underscores the importance of considering PLCH in the differential diagnosis of pulmonary nodules, particularly in patients with a significant smoking history, and contributes to the growing body of knowledge regarding the diverse presentations of LCH in adults.

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