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

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. (Korean J Med 2013;85:199-204)