CTICasesCoexisting Langerhans Cell Histiocytosis and Growing Pulmonary Hamartoma
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Imaging findings
In 2003, a smoker presented with typical findings of Langerhans cell histiocytosis (LCH), including a fine lacy reticular pattern, numerous small cysts, scattered nodules, and basal sparing. A small, soft-tissue attenuation nodule was also present in the right middle lobe. By 2008, this nodule had grown and developed macroscopic fat. By 2014, the lesion was significantly larger, exhibiting a lobulated interface with internal or adjacent air spaces. Active LCH nodules persisted.
Key takeaways
This case illustrates the concurrent presence of Langerhans cell histiocytosis and a pulmonary hamartoma. The hamartoma's notable growth over 12 years and its unusual air-containing, lobulated interface raised questions about its benign nature or potential for atypical features, such as low-grade liposarcoma, or an interaction with LCH cysts or airways. Continued smoking likely contributed to the ongoing activity of LCH, and the growth of the hamartoma raised concerns about potential lobectomy.
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