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Volume 12
Issue 6
10.3390/diagnostics12061394
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Interesting Images

Bronchoalveolar Lavage as a Diagnostic Tool in an Atypical Pulmonary Langerhans Cell Histiocytosis

by
Ovidiu Fira-Mladinescu
1,2,3,
Noemi Suppini
1,2,
Gheorghe-Emilian Olteanu
1,2,
Corneluta Fira-Mladinescu
3,* and
Daniel Traila
1,2
1
Center for Research and Innovation in Personalised Medicine of Respiratory Diseases, XIIIth Department—Pulmonology Discipline, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
2
Center of Expertise for Rare Lung Diseases, Clinical Hospital of Infectious Diseases and Pneumophthisiology “Dr. Victor Babes” Timisoara, Gh. Adam Street no. 13, 300310 Timisoara, Romania
3
Research Centre in Preventive Medicine, XIVth Department—Hygiene Discipline, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. no. 2, 300041 Timișoara, Romania
*
Author to whom correspondence should be addressed.
Diagnostics 2022, 12(6), 1394; https://doi.org/10.3390/diagnostics12061394
Submission received: 16 May 2022 / Revised: 1 June 2022 / Accepted: 2 June 2022 / Published: 4 June 2022
(This article belongs to the Special Issue Advances in Cardiopulmonary Imaging)
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Abstract

Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon diffuse cystic lung disease that occurs almost exclusively in young adult smokers. High-resolution computed tomography of the chest allows a confident diagnosis of PLCH in typical presentation, when nodules, cavitating nodules, and cysts coexist and show a predominance for the upper and middle lung. Atypical presentations require histology for diagnosis. Histologic diagnosis rests on the demonstration of increased numbers of Langerhans cells and/or specific histological changes. PLCH is one of the few diseases in which bronchoalveolar lavage (BAL) has a high diagnostic value and can in some circumstances replace lung biopsy. We present a case of PLCH in an elderly non-smoker. Chest imaging revealed the presence of advanced interstitial lung disease with a fibrocystic pattern. BAL cellular analyses disclosed a macrophage pattern with CD1a phenotype that strongly supports the PLCH diagnosis, even in the setting of atypical clinical presentation and a lack of smoking exposure. PLCH is extremely rare in non-smokers and could represent a distinct phenotype.
Keywords: multiple cystic lung disease; cytopathologic diagnosis; immunohistochemical cell blocks multiple cystic lung disease; cytopathologic diagnosis; immunohistochemical cell blocks

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MDPI and ACS Style

Fira-Mladinescu, O.; Suppini, N.; Olteanu, G.-E.; Fira-Mladinescu, C.; Traila, D. Bronchoalveolar Lavage as a Diagnostic Tool in an Atypical Pulmonary Langerhans Cell Histiocytosis. Diagnostics 2022, 12, 1394. https://doi.org/10.3390/diagnostics12061394

AMA Style

Fira-Mladinescu O, Suppini N, Olteanu G-E, Fira-Mladinescu C, Traila D. Bronchoalveolar Lavage as a Diagnostic Tool in an Atypical Pulmonary Langerhans Cell Histiocytosis. Diagnostics. 2022; 12(6):1394. https://doi.org/10.3390/diagnostics12061394

Chicago/Turabian Style

Fira-Mladinescu, Ovidiu, Noemi Suppini, Gheorghe-Emilian Olteanu, Corneluta Fira-Mladinescu, and Daniel Traila. 2022. "Bronchoalveolar Lavage as a Diagnostic Tool in an Atypical Pulmonary Langerhans Cell Histiocytosis" Diagnostics 12, no. 6: 1394. https://doi.org/10.3390/diagnostics12061394

APA Style

Fira-Mladinescu, O., Suppini, N., Olteanu, G.-E., Fira-Mladinescu, C., & Traila, D. (2022). Bronchoalveolar Lavage as a Diagnostic Tool in an Atypical Pulmonary Langerhans Cell Histiocytosis. Diagnostics, 12(6), 1394. https://doi.org/10.3390/diagnostics12061394

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