Elsevier

Mayo Clinic Proceedings

Volume 76, Issue 2, February 2001, Pages 209-211
Mayo Clinic Proceedings

Case Reports
Pulmonary Langerhans Cell Histiocytosis Presenting as a Solitary Nodule

https://doi.org/10.4065/76.2.209Get rights and content

Solitary pulmonary nodules are an uncommon manifestation of pulmonary Langerhans cell histiocytosis (PLCH). We describe a 45-year-old male cigarette smoker who presented with an asymptomatic solitary pulmonary nodule that showed histologic and immunophenotypic characteristics of PLCH. Twenty-one years after excision of the nodule, at the age of 66 years, he is asymptomatic with a new contralateral lung nodule but no evidence of interstitial disease. The new nodule has remained unchanged after 36 months of observation. This case affirms that PLCH can occasionally cause solitary lesions, which should not be interpreted as a harbinger of interstitial lung disease. Isolated PLCH should be included in the differential diagnosis of unusual solitary pulmonary nodules.

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REPORT OF A CASE

A 45-year-old male cigarette smoker presented with an asymptomatic solitary pulmonary nodule in the left upper lobe. He underwent thoracotomy and wedge excision of the lesion. After the operation, he continued to smoke. Twenty-one years later, at the age of 66 years, he presented with a new asymptomatic solitary nodule in the right upper lobe. Computed tomography showed only a single pulmonary nodule with no evidence of interstitial lung disease. Since the second lesion was benign by

DISCUSSION

In our patient, PLCH presented as an asymptomatic solitary pulmonary nodule, a rare manifestation of this disease. To our knowledge, only 3 similar patients have been described,2, 3, 4 only 2 in the peer-reviewed literature.2, 4

Fichtenbaum et al2 described a 58-year-old man with a 42-pack-year history of cigarette smoking in whom a nodule (1.0 cm in greatest dimension) was detected in the right middle lobe on a preoperative chest radiograph. He was asymptomatic with no radiographic

REFERENCES (13)

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