Improvement of Both Pulmonary and Hepatic Lesions of Adult Langerhans Cell Histiocytosis After Short-term Smoking Cessation

Abstract

Background. Langerhans cell histiocytosis (LCH) is a disease in which Langerhans cells derived from dendritic cells infiltrate a various organs and is considered smoking-related lung disease. Case. A 27-year-old woman with a 10-year smoking history was referred to our institution with dry cough and dyspnea on exertion. Chest radiographs showed reticulonodular opacities in the bilateral lung fields. High-resolution CT revealed a thin wall cavitary lesions about 10 mm in diameter and multiple small nodules. Transbronchial lung biopsy specimens revealed peribronchiolar granulomatous lesions with infiltrations of Langerhans cells and eosinophils and we made a diagnosis of LCH. Dynamic MRI of the liver showed small nodules with high intensity and large nodules with ring enhancement in the arterial phase, and hepatomegaly. Percutaneous liver biopsy specimens revealed accumulation of Langerhans cells. After smoking cessation for 3 months, both pulmonary and liver lesions improved rapidly. Conclusion. Smoking cessation is the key strategy for not only pulmonary LCH but also hepatic lesions at an early stage.