A case of pulmonary Langerhans cell histiocytosis discovered by CT mass screening and follwed by bronchoalveolar lavage
Hiroshi Watanabe1) Makoto Maemondo1) Shinya Okouchi1) Takuji Suzuki1) Toshiaki Kikuchi1) Ryushi Tazawa1) Masahito Ebina1) Yasuo Saijo1) Yasushi Hoshikawa2) Toshihiro Nukiwa1)
1)Department of Respiratory Oncology and Molecular Medicine, 2)Department of Thoracic Surgery, Insititute of Development, Aging and Cancer, Tohoku University
A 42-year-old woman who had a cigarette index of 420 had many cavitary lesions predominantly in the upper areas of both lungs. The lesions were detected on a health examination using CT. Analysis with bronchofiberscopy showed increased CD1a positive cells in bronchoalveolar fluid (BALF). Histological examination by video-associated lung biopsy demonstrated that both S-100 and vimentin-positive cells were present in the peribronchial fibrotic lesions. From these data, this disease was diagnosed as pulmonary Langerhans cell histiocytosis (PLCH). Three months after the cessation of smoking, the cavity lesions disappeared. As the image findings improved, CD1a positive cells in BALF decreased (4.9%→1.8%) and the CD4/CD8 ratio in BALF increased (1.66→6.16). So far, there is no report describing the time course of both CD1a positive cells and CD4/CD8 ratio in BALF after cessation of smoking in PLCH. These findings attract our interest on the PLCH.
Pulmonary Langerhans cell histiocytosis (PLCH) Cessation of smoking Bronchoalbeolar lavage (BAL) CD1a CD4/CD8 ratio
Received 平成18年3月6日
JJRS, 44(11): 869-873, 2006