PULMONARY LANGERHANS CELL HISTIOCYTOSIS IN A YOUNG ADULT SMOKER: A CASE REPORT

Abstract

Introduction Pulmonary Langerhans Cell Histiocytosis (PLCH) remains a rare and enigmatic disorder among interstitial lung diseases, primarily targeting young adult smoker. It becomes a diagnostic challenge due to its variable clinical manifestations and radiological features.  Case Presentation A 27-year-old male with a significant smoking history presented with progressive dyspnea and pleuritic chest pain. High-resolution computed tomography (HRCT) of the chest revealed classic findings of multiple nodules, cavitary lesions, and cysts with upper and mid-lung predominance, complicated by a spontaneous pneumothorax. A diagnosis of PLCH was made based on the clinical and radiological characteristics. The patient was treated with emergent chest tube insertion. Afterward, he also received a nine-day course of high-dose systemic corticosteroids and broad-spectrum antibiotics. Following stabilization of his acute condition and completion of these interventions, rigorous implementation of smoking cessation counseling was performed. Follow-up at eight months revealed significant symptomatic relief and notable radiological regression of lesions on HRCT Conclusions This case underscores the pivotal role of HRCT in the non-invasive diagnosis of PLCH in order to determine the acute management strategies required for life-threatening complications and reaffirms smoking cessation as the most potent long-term therapeutic intervention.