medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2002, Number 1

<< Back Next >>

An Med Asoc Med Hosp ABC 2002; 47 (1)

Langerhans cell histiocytosis and pulmonary tuberculosis, fortuitous association? Case report and

Videgaray F, Martínez M, Maldonado P, Zulaica H, Vázquez E

Language: Spanish
References: 29
Page: 38-43
PDF size: 45.98 Kb.


ABSTRACT

Langerhans cell histiocytosis is a disease of unknown etiology characterized by the presence of granulomas that contain many Langerhans cells. There can be involvement of the lung, bone, skin, pituitary, lymph nodes and other less common sites such as Central Nervous System, liver, spleen and thyroid and it can manifest itself as a localized or multifocal disease. Pulmonary Langerhans cell histiocytosis refers to disease which affects only the lungs or the lung and other organs as well. No factors such as genes or gender predominance have been related to the disease except for cigarette smoking, although an infectious etiology has been suggested. Non-productive cough, dyspnea, weight loss, fever diaphoresis and anorexia are the most common symptoms. The diagnosis is clinical and histopathological. Treatment consists of suspending cigarette smoking, and administration of corticosteroids and antiinflamatories. We present the case of a 44 year old male with the diagnosis of Pulmonary Langerhans cell Histiocytosis. He was diagnosed because of the finding of a pulmonary nodule which was surgically removed and for which the anatomopathological result was: caseous necrosis compatible with tuberculosis and Langerhans cell Histiocytosis. We tried to correlate these two entities.


REFERENCES

  1. Nezelof C, Basset F. Langerhans cell histiocytosis. Hematol Oncol Clin North Am 1998; 12: 213-458.

  2. Favara BE, Feller AC, Pauli M, et al. Contemporary classification of histiocytic disorders. Med Pediatr Oncol 1997: 29.

  3. Bravencova E, Abdellatif T et al. Langerhans cell granulomatosis are not actively proliferating cells. Am J Pathol 1998: 152.

  4. Howarth DM, Gilchrist GS, Mullan BP, Wiseman GA, Edmondson J, Schomberg PJ. Langerhans cell histiocytosis: Diagnosis, natural history, management, and outcome. Cancer 1999: 85.

  5. Vassallo R, Jay H, Ryu, et al. Pulmonary Langerhans’-cell histiocytosis. N Engl J Med 2000: 342.

  6. Gaensler EA, Carrington CB. Open biopsy for chronic diffuse infiltrative lung disease: Clinical, roentgenographic, and physiological correlations in 502 patients. Ann Thorac Surg 1980: 30.

  7. Friedman PJ, Liebow AA, Sokoloff J. Eosinophilic granuloma of lung: Clinical aspects of primary histiocytosis in the adult. Medicine (Baltimore) 1981; 60: 385-396.

  8. Colby TV, Lombard C. Histiocytosis X in the lung. Hum Pathol 1983; 14: 847-856.

  9. Travis WD, Borok Z, Roum JH et al. Pulmonary Langerhans’ cell granulomatosis (histiocytosis X): A clinicopathologic study of 48 cases. Am J Surg Pathol 1993; 17: 971-986.

  10. Zeid NA, Muller HK. Tobacco smoke induced lung granulomas and tumors: Association with pulmonary Langerhans’ cells. Pathology 1995; 27: 247-254.

  11. Blaise E, Favara. Langerhans cell histiocytosis pathobiology and pathogenesis. Semin Oncol 1991; 18 (1): 3-7.

  12. Chistine H, Cheryl L et al. Langerhans cell histiocytosis immunophenotype and growth fraction. Human Pathology 1993; 24: 840-845.

  13. Mechanism of necrotizing granuloma formation and its function. Kekkaku 1994; 69: 627-649.

  14. Willman CL, Busque L, Griffith BB, et al. Langerhans-cell histiocytosis (Histiocytosis X)-A clonal proliferative disease. N Engl J Med 1994; 331: 154-160.

  15. Liberman, et al. Langerhans cell (Eosinophilic) granulomatosis a clinicopathologic study encompassing 50 years. Am J Surg Pathol 1996; 20: 519-551.

  16. Maureen A, et al. Human herpesvirus 6 is present in lesions of Langerhans cell histiocytosis. J Invest Dermatol 1993; 101: 642-645.

  17. Francus T, Klein RF, Staiano-Coico L, Becker CG, Siskind GW. Effects of tobacco glycoprotein (TGP) on the immune system. II. TGP stimulates the proliferation of human T cells and the differentiation of human B cells into Ig secreting cells. J Immunol 1988; 140: 1823-1829.

  18. Crausman RS, Jennings CA, Tuder RM, Ackerson LM, Irvin CG, King TE Jr. Pulmonary histiocytosis X: Pulmonary function and exercise pathophysiology. Am J Respir Crit Care Med 1996; 153: 426-435.

  19. Lacronique J, Roth C, Battesti JP, Basset F, Chretien J. Chest radiological features of pulmonary histiocytosis X: A report based on 50 adult cases. Thorax 1982; 37: 104-109.

  20. Minghini A, et al. Recurrent spontaneus pneumothorax in pulmonary histiocitosis X. Am Surgeon 1998; 64: 1040-1042.

  21. Velde GP, Thunnissen FB, van Engelshoven JM, Wouters EF. A solitary pulmonary nodule due to eosinophilic granuloma. Eur Respir J 1994; 7: 1539-1540.

  22. Fichtenbaum CJ, Kleinman GM, Haddad RG. Eosinophilic granuloma of the lung presenting as a solitary pulmonary nodule. Thorax 1990: 45: 905-906.

  23. Bonelli FS, Hartman TE, Swenson SJ, Sherrick A. Accuracy of high-resolution CT in diagnosing lung diseases. Am J Roentgenol 1998; 170: 1507-1512.

  24. Brauner MW, Grenier P, Mouelhi MM, Mompoint D, Lenoir S. Pulmonary histiocytosis X: Evaluation with high-resolution CT. Radiology 1989; 172: 255-258.

  25. Mogulkoc N, Veral A, Bishop PW, Bayindir U, Pickering CA, Egan JJ. Pulmonary Langerhans’ cell histiocytosis: Radiologic resolution following smoking cessation. Chest 1999; 115: 1452-1455.

  26. Von Essen S, West W, Sitorius M, Rennard SI. Complete resolution of roentgenographic changes in a patient with pulmonary histiocytosis X. Chest 1990; 98: 765-767.

  27. Cruthirds TP, Johnson HR. Solitary primary eosinophilic granuloma of lung. JAMA 1966; 196: 295-296.

  28. Zolotarev VP, Krylov VV, Platonov IuF, Ershov VN. Recurrence of pulmonary tuberculosis in a patient with histiocytosis X. Probl Tuberk 1989; 9: 74-75.

  29. Fenhalls G, Stevens L, Bezuidenhout J, Amphiett GE, Duncan K, Bardin P, Lukey PT. Distribution of IFN-gamma, IL-4 and TNF-alpha protein and CD8T cells producing Il-12p40 mRNA in human lung tuberculous granulomas. Immunology 2002; 105 (3): 325-335.




2020     |     www.medigraphic.com