Case Report
Pulmonary Langerhans Cell Histiocytosis with Lytic Bone Involvement in an Adult Smoker: Regression following Smoking Cessation
Table 1
Studies on pulmonary Langerhans cell histiocytosis with extrapulmonary manifestations.
| Authors | Number of pts. | Pathological confirmation of PLCH | Extrapulmonary sites | Treatment | Outcome |
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Vassallo et al. [5, 11] | 17 | Surgical or transbronchoscopic lung biopsy | Pituitary = 9, bone = 7, skin = 4, lymph node or liver = 4 | Prednisone + chemotherapy (vinblastine 7 pts., methotrexate, cyclophosphamide, etoposide, and cladribine 2 pts., respectively | Mixed results with improvement and refractory cases-overall survival shorter than for aged-matched healthy individuals |
| Karpathiou et al. [12] | 1 | Thoracoscopic biopsy | Bone: right humerus-biopsy revealed LCH | Smoking cessation | Resolution of the bone without intervention and once patient stopped smoking pulmonary manifestation resolved |
| Shih et al. [13] | 1 | Lung biopsy | Bone: skull and one rib discovered on imaging using Technetium-99m | Not reported | Unknown |
| Nakamura et al. [14] | 1 | Open lung biopsy | Pituitary: panhypopituitary confirmed on endocrinology testing | Smoking cessation and subsequently methylprednisolone pulse therapy | Disappearance of the pulmonary findings, but patient remained with panhypopituitary dysfunction |
| Medoff et al. [15] | 1 | Video assisted surgical biopsy | Bone: left scapular spine and left femur | Smoking cessation + corticosteroid injections in the bone lesions | Almost complete resolution on CT chest 3 months later; bone X-ray 9 months later showed healing with callus formation |
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