대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Courtesy

Ewha Womans University Mokdong Hospital

Discussion

Langerhans cell histiocytosis (histiocytosis X, eosinophilic granuloma)
- Early stage : nodular collections of Langerhans histiocytes and eosinophils (juxtabronchiolar )
- Late stage : fibrosis, honeycombing

- young or middle-aged adults, male predominance, ciagrette smoking history (> 90%), pneumothorax (14%)
- variable PFT pattern/ decreased diffusing capacity
- 60% (lung), 40% (lung + bone, other organ)
- Px : 1/2 favorable, 1/3 stable, 20% progress ( respiratory failure, pulmonary a. HT)

CXR
- nodular, reticulonodular, and cystic abnormalities (upper lung >>)

Evolution on CT
Nodule (1-5mm, centrilobular and peribronchiolar) -> cavitary nodule & thick-walled cyst -> cyst (large confluent, bizarre) -> GGA, irregular lines & honeycombing

End-stage lung disease
- UIP (43%), sarcoidosis (15%), HX (13%), asbestosis, EAA, silicosis, LAM

Keywords

Lung, Interstitial lung disease, LCH,