Difficulties in the diagnosis of rare immunological diseases manifesting with cystic lung disease and spontaneous pneumothorax: case reports

Pulmonary langerhans cell histiocytosis with recurrent pneumothorax

A 20-year-old woman with recurrent right pneumothorax was admitted to our hospital. A thoracoscopic bullectomy and lung biopsy was performed under general anesthesia. According to the histopathologic findings of permanent sections, a tissue specimen of diffuse lung disease revealed eosinophil infiltration and the presence of fibroblasts. Immunohistochemical stain showed S-100 protein-positive, as well as cluster of differentiation-68-positive large Langerhans cells. As a result, pulmonary Langerhans cell histiocytosis was diagnosed. The patient had an uncomplicated postoperative course and was discharged from the hospital on postoperative day 5. No recurrence was observed during the 6-month observation period.