Adult langerhans cell histiocytosis with independently relapsing lung and liver lesions that was successfully treated with etoposide
Adult langerhans cell histiocytosis with independently relapsing lung and liver lesions that was successfully treated with etoposide
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DOI：
10.2169/internalmedicine.46.6433
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发表时间：
2007-01-01
影响因子：
1.2
通讯作者：
Nishimura, Masaharu
中科院分区：
文献类型：
--
作者：
Konno, Satoshi;Hizawa, Nubuyuki;Nishimura, Masaharu
一名 35 岁男子最初出现咳嗽和发烧症状。计算机断层扫描（CT）显示肺部有弥漫性小囊肿，肝脏有多个结节。肺和肝活检显示病理学与朗格汉斯细胞组织细胞增多症一致。尽管戒烟，肺部阴影仍增加，而肝脏受累情况有所改善。开始泼尼松龙治疗后，胸部 CT 检查结果有所改善。然而，随着泼尼松龙逐渐减少，肝脏结节开始增加。开始静脉注射依托泊苷，肝结节明显减少。肺和肝病变之间临床病程的差异可能是由于这两个器官的克隆性差异造成的。
A 35-year-old man initially presented with cough and fever. Computed tomography (CT) revealed diffuse small cysts in the lung, and multiple nodules in the liver. Lung and liver biopsies revealed that pathology was consistent with Langerhans cell histiocytosis. Lung shadows increased despite cessation of smoking, whereas the liver involvement improved. After initiating treatment with prednisolone, the chest CT findings improved. However, the liver nodules started to increase while tapering prednisolone. Intravenous etoposide was started, and the liver nodules decreased markedly. The difference in the clinical course between the lung and liver lesions might have been the result of differences in the clonality of these two organs.