CTICasesPulmonary Langerhans Cell Histiocytosis with Extrapulmonary Bone Involvement
Imaging findings
Serial CT scans over one year show the classic progression of pulmonary Langerhans cell histiocytosis (PLCH) in a smoker, demonstrating a transition from nodules to bizarrely shaped, upper-lung predominant cysts with relative sparing of the lung bases. Additionally, the CT shows a soft tissue nodule and fracture of an adjacent rib, along with a punched-out, lytic lesion in a lumbar vertebral body.
Key takeaways
PLCH is a smoking-related interstitial lung disease defined by a bronchiolocentric progression from solid or cavitary nodules to thick- and thin-walled cysts. While typically limited to the lungs in adults, extrapulmonary bone involvement can occasionally occur, presenting as punched-out lytic lesions without periosteal reaction.
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