Pulmonary Langerhans Cell Histiocytosis Associated with Bronchogenic Carcinoma

Abstract

Pulmonary Langerhans cell histiocytosis (PLCH, pulmonary eosinophilic granuloma) is a rare disease of clonal dendritic cells that primarily affects adults who smoke cigarettes. PLCH association with other malignancies is rarely reported. Herein, an unusual case of PLCH is presented with synchronous lung adenocarcinoma. A 76-year-old woman and chronic smoker was admitted for persistent dyspnea and productive cough, and had a left lower lung mass detected by computed tomography. She underwent bronchoscopy with biopsies. Histopathological analysis was negative, but cultures grew Mycobacterium avium complex. She subsequently underwent lobectomy and was found to have papillary adenocarcinoma with PLCH in the surrounding lung nodules.

Keywords: lung adenocarcinoma; mycobacterium avium complex; pulmonary langerhans cell histiocytosis.

Figure 1. Left basilar consolidation seen on chest X-ray.

Figure 2. Chest CT showing mass-like consolidation surrounded by nodules.

Figure 3. Positron emission tomography examination revealing worsening consolidation within the left lower lobe with moderate intensity standardized uptake value maximum of 4.3 noted within the infrahilar region. No abnormal uptake noted in hila, mediastinum, or abdomen.