Sugihara Minoru, Okamoto Sawako, Taniguchi Tetsuo
Department of Thoracic Surgery Komaki City Hospital Komaki Japan.
Respirol Case Rep. 2024 Sep 18;12(9):e70028. doi: 10.1002/rcr2.70028. eCollection 2024 Sep.
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.
肺朗格汉斯细胞组织细胞增多症（PLCH）是朗格汉斯细胞组织细胞增多症的一种亚型，是一种以肺部受累为特征的罕见肿瘤性疾病。在此，我们报告一例病例，该患者有多个空洞性结节，在肺癌手术后的监测期间被诊断为PLCH。一名74岁女性5年前因右上叶肺腺癌（pStage IIA）接受了右上叶切除术。患者未接受辅助化疗，而是进行了监测。在随访的第五年，胸部计算机断层扫描显示双肺野有多个空洞性结节。考虑到疑似肺癌复发，曾考虑进行化疗；然而，由于需要进行生物标志物检测，最终实施了电视辅助胸腔镜手术。病理检查确诊为PLCH。该病例强调了即使在临床怀疑肺癌复发的情况下，积极进行组织学诊断以确定适当治疗策略的重要性。
