Uskul Bahadir T, Turker Hatice, Bayraktar Ozge Unal, Onemli Meliha
Department of Chest Diseases, 1st Clinic of Chest Diseases and Tuberculosis, Sureyyapasa Chest Diseases and Thoracic Surgery Hospital, Istanbul, Turkey.
Intern Med. 2009;48(5):359-62. doi: 10.2169/internalmedicine.48.1552. Epub 2009 Mar 2.
A 30-year-old man patient was admitted to our clinic with complaints including cough, dyspnea, and chest pain. He had been diagnosed with pulmonary Langerhans' cell histiocytosis (LCH) 9 years previously. HRCT of the thorax demonstrated the presence of diffuse emphysematous areas in both lungs with a honeycomb appearance, an increase in reticular density at the lower lobes, a mass lesion in the left hilus, and a mass lesion at the lower lobe of the left lung. Histological diagnosis of TBNA from the right lower paratracheal and subcarinal lymph nodes was adenocarcinoma. Chemotherapy was begun, but the patient died due to respiratory failure after two courses of chemotherapy. We present this case as an example of the rare development of bronchogenic carcinoma during the long-term course of LCH.
一名30岁男性患者因咳嗽、呼吸困难和胸痛等症状入院。他9年前被诊断为肺朗格汉斯细胞组织细胞增多症（LCH）。胸部HRCT显示双肺存在弥漫性肺气肿区域，呈蜂窝状外观，下叶网状密度增加，左肺门有一肿块病变，左肺下叶也有一肿块病变。经支气管针吸活检（TBNA）对右下气管旁和隆突下淋巴结进行组织学诊断为腺癌。开始化疗，但患者在两个疗程的化疗后因呼吸衰竭死亡。我们将此病例作为LCH长期病程中罕见发生支气管源性癌的一个例子进行展示。
