Pulmonary Langerhans cell histiocytosis

Case contributed by Dr Laughlin Dawes


This male patient has respiratory failure and is awaiting a lung transplant. He presented with an infective exacerbation of his disease.

Patient Data

Age: 40 years
Gender: Male


The plain frontal chest x-ray shows mild hyperinflation and a coarse pattern in the lung fields consisting of reticular interstitial markings and peripheral ring shadows suggesting cysts.

Case Discussion

High-resolution CT confirmed the presence of multiple small peripheral cystic lesions, some of which were branching and bizarre. There was honeycombing in the lower zones. There were a few small peribronchovascular nodules and there was interlobular septal thickening. The differential diagnosis of multiple pulmonary cystic lesions includes Langerhans cell histiocytosis, lymphangioleiomyomatosis, sarcoidosis and lymphocytic interstitial pneumonitis. Peripheral bronchiectasis should be considered as it may appear cystic. Given the other changes seen on HRCT and the patient’s sex, LCH was the favored imaging diagnosis.

Image contributed by: Dr Laughlin Dawes

PlayAdd to Share

Case information

rID: 35847
Published: 6th May 2015
Last edited: 14th Jan 2020
System: Chest
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.