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A Case of Langerhans Cell Histiocytosis Involving the Lung and Spine of an Adult Patient

폐와 척추를 침범한 랑게르한스 세포 조직구증 1예

  • Lee, Chi Hoon (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Kang, Sung Wook (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Kim, Dong Hee (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Min, Joon Ki (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Kim, Yee Hyung (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Choi, Cheon Woong (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Yoo, Jee-Hong (Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine)
  • 이치훈 (경희대학교 의과대학 강동경희대학교병원 호흡기내과) ;
  • 강성욱 (경희대학교 의과대학 강동경희대학교병원 호흡기내과) ;
  • 김동희 (경희대학교 의과대학 강동경희대학교병원 호흡기내과) ;
  • 민준기 (경희대학교 의과대학 강동경희대학교병원 호흡기내과) ;
  • 김이형 (경희대학교 의과대학 강동경희대학교병원 호흡기내과) ;
  • 최천웅 (경희대학교 의과대학 강동경희대학교병원 호흡기내과) ;
  • 유지홍 (경희대학교 의과대학 강동경희대학교병원 호흡기내과)
  • Received : 2012.12.20
  • Accepted : 2013.03.14
  • Published : 2013.08.01

Abstract

Langerhans cell histiocytosis (LCH) is a proliferative disease that shares phenotypic characteristics with Langerhans cells (LCs) and involves multiple organs. Here, we report a case of LCH in a 36-year-old male simultaneously involving the lungs and thoracic spine. Chest computed tomography (CT) showed multifocal thin-walled cysts and ill-defined nodular opacities primarily in the bilateral upper and middle lung lobes that fluctuated with smoking. Despite improvement of pulmonary lesions after smoking cessation, osteolytic lesion of thoracic vertebra was aggravated. Symptoms were not improved after nerve block, suggesting vertebral instability that necessitated surgical mass removal and posterior fusion. Microscopically diffuse proliferation of immature, rounded LCs and inflammatory cell infiltration was noted. Although pulmonary LCH in an adult is a benign disease that is usually resolved spontaneously after smoking cessation, surgical treatment should be considered in a case of spinal LCH.

랑게르한스 세포 조직구증은 드문 조직구 질환의 하나로서 랑게르한스 세포가 증식하여 뼈를 비롯한 여러 장기를 침범하는 질환이다. 성인에서 폐와 함께 척추를 침범한 경우는 드물게 보고되고 있다. 저자들은 흡연력이 있는 젊은 남성에서 폐 병변은 금연에 의해 호전되었지만 척추 병변은 금연에도 불구하고 악화되어 심한 통증을 유발하고 척추 안정성에 문제를 보여 이를 수술적으로 치료한 1예를 경험하였기에 보고하는 바이다.

Keywords

References

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