Correct!
1. The repeat HRCT shows numerous small, somewhat randomly scattered nodules unchanged from the previous thoracic CT (Figure 3)

The patient was referred to cardiothoracic surgery for surgical lung biopsy. Video-assisted thoracoscopic lung biopsy was attempted, but, owing to technical difficulties and inability to obtain adequate one-lung ventilation, was converted to an open thoracotomy for lung biopsy. Histopathological material obtained from lingular biopsy showed active smoking-related changes with cysts and stellate nodules consistent with both active and inactive Langerhans cell histiocytosis.

Diagnosis: Pulmonary Langerhans Cell Histiocytosis

If you wish to receive 0.25 AMA PRA Category 1 Credit(s)™, click here.

References

  1. Seaman DM, Meyer CA, Gilman MD, McCormack FX. Diffuse cystic lung disease at high-resolution CT. AJR Am J Roentgenol. 2011; 196(6):1305-11. [CrossRef] [PubMed]
  2. Seely JM, Salahudeen S Sr, Cadaval-Goncalves AT, Jamieson DH, Dennie CJ, Matzinger FR, Souza CA. Pulmonary Langerhans cell histiocytosis: a comparative study of computed tomography in children and adults. J Thorac Imaging. 2012;27(1):65-70. [CrossRef] [PubMed]
  3. Sundar KM, Gosselin MV, Chung HL, Cahill BC. Pulmonary Langerhans cell histiocytosis: emerging concepts in pathobiology, radiology, and clinical evolution of disease. Chest. 2003;123(5):1673-83. [CrossRef] [PubMed]
  4. Vassallo R, Harari S, Tazi A. Current understanding and management of pulmonary Langerhans cell histiocytosis. Thorax. 2017;72(10):937-45. [CrossRef] [PubMed]
  5. Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. part I. Am J Respir Crit Care Med. 2015;191(12):1354-66. [CrossRef] [PubMed]
  6. Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. part II. Am J Respir Crit Care Med. 2015;192(1):17-29. [CrossRef] [PubMed]
  7. Vassallo R, Ryu JH. Pulmonary Langerhans' cell histiocytosis. Clin Chest Med. 2004; 25(3):561-71. [CrossRef] [PubMed]

Home/Imaging