Pulmonary Langerhans cell histiocytosis with multiple cavitary nodules after lung cancer surgery

• Published in: Respirology case reports 2024-09, Vol.12 (9), p.e70028-n/a
• Main Authors: Sugihara, Minoru, Okamoto, Sawako, Taniguchi, Tetsuo
• Format: Article
• Language: English
• Subjects: Autoimmune diseases; Biomarkers; Biopsy; Cancer surgery; Case Report; Chemotherapy; Embolisms; Lung cancer; Metastasis; multiple pulmonary nodules; pulmonary Langerhans cell histiocytosis; Smoking cessation; Surveillance; Thoracic surgery; Tomography
• ISSN: 2051-3380; 2051-3380
• DOI: 10.1002/rcr2.70028

Pulmonary Langerhans cell histiocytosis (PLCH) is a subtype of Langerhans cell histiocytosis, a rare neoplastic disease characterized by lung involvement. Here, we present a case involving a patient with multiple cavitary nodules who was diagnosed with PLCH during surveillance after lung cancer surgery. A 74‐year‐old woman underwent right upper lobe resection surgery for right upper lobe lung adenocarcinoma, pStage IIA, 5 years ago. The patient underwent surveillance without adjuvant chemotherapy. During the fifth year of follow‐up, multiple nodules with cavitation were observed on computed tomography in both lung fields. Chemotherapy was considered to address the suspected recurrence of lung cancer; however, video‐assisted thoracoscopic surgery was performed due to the need for biomarker testing. Pathological examination led to the diagnosis of PLCH. This case emphasizes the importance of a proactive histological diagnosis to determine the appropriate treatment strategy, even in situations where lung cancer recurrence is clinically suspected. Pulmonary Langerhans cell histiocytosis is a subtype of Langerhans cell histiocytosis, a rare neoplastic disease characterized by lung involvement. We report a case of Pulmonary Langerhans cell histiocytosis that was diagnosed through the detection of multiple cavitary nodules in both lung fields during surveillance after lung cancer surgery.