Chest
Volume 115, Issue 5, May 1999, Pages 1452-1455
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Selected Reports
Pulmonary Langerhans’ Cell Histiocytosis: Radiologic Resolution Following Smoking Cessation

https://doi.org/10.1378/chest.115.5.1452Get rights and content

We describe two patients with histologically proven pulmonary Langerhans’ cell histiocytosis in whom radiologic improvement occurred following smoking cessation. The patients had 23- and 25-pack-year smoking histories, respectively. High-resolution CT revealed multiple small nodules, located predominantly in the upper and middle lung fields. There was a close temporal relationship between smoking cessation and radiologic improvement.

Section snippets

Case 1

A 43-year-old woman was admitted to the hospital with a 3-month history of a nocturnal cough associated with intermittent chest tightness. She had been previously well with no history of dust or chemical exposures. She was a smoker, starting at the age of 20 years and averaging 20 cigarettes a day. Physical examination revealed sparse fine late inspiratory crackles at both bases. Breast examination was normal. Routine hematologic studies were normal; there was no peripheral eosinophilia, the

Discussion

The etiology of LCH remains obscure, but the vast majority (up to 97%) of the patients are current smokers or ex-smokers. The course of this disease is variable, ranging from spontaneous remission to progressive disease and death.14 Since remission of the LCH may occur spontaneously even in those who continue to smoke,5 the effect of smoking cessation is often difficult to resolve. We describe two patients in whom there was a close temporal and sustained relationship between smoking cessation

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