Pulmonary Langerhans cell histiocytosis in a young adult with a history of vaping and smoking: A case report

Authors

  • Boripat Hirunpat M.D. Department of Radiology, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand.
  • Wiwatana Tanomkiat M.D. Department of Radiology, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand.
  • Itchaya Kongmee M.D. Division of Respiratory and Respiratory Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand.
  • Wichaya Soonsuwon M.D. Department of Pathology, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand.
  • Warat Setasuban M.D. Department of Radiology, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand.

Keywords:

Cystic lung disease, Pneumothorax, Pulmonary Langerhans cell histiocytosis, Smoking, Vaping

Abstract

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease characterized by the proliferation of Langerhans cells, typically associated with smoking. It accounts for 3%-5% of adult diffuse lung diseases, although the true prevalence may be higher due to asymptomatic cases and diagnostic challenges. Recently, e-cigarette use (vaping) has emerged as a potential contributing factor in PLCH. We report the case of an 18-year-old male with a history of heavy nicotine vaping and prior light smoking who presented with pneumothorax and diffuse cystic lung lesions. Lung biopsy confirmed PLCH through CD1a and S100 positivity. Smoking cessation led to symptomatic and functional improvement, although long-term outcomes remain uncertain. This case highlights vaping as a possible risk factor for PLCH, distinct from traditional smoking, and underscores the need for further research into vaping-related pulmonary diseases. A multidisciplinary approach is essential for the diagnosis and management of PLCH.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Buhtoiarov IN, Mukherjee S, Radivoyevitch T. Incidence, Clinical Features, and Outcomes of Langerhans Cell Histiocytosis in the United States. Journal of Pediatric Hematology/Oncology. 2022 Jan 26;44(7).

Vassallo R, Harari S, Tazi A. Current understanding and management of pulmonary Langerhans cell histiocytosis. Thorax. 2017 Jul 8;72(10):937–45.

Wang FF, Liu YS, Zhu WB, Liu YD, Chen Y. Pulmonary Langerhans cell histiocytosis in adults: A case report. World Journal of Clinical Cases. 2019 Jul 26;7(14):1892–8.

Lorillon G, Tazi A. How I manage pulmonary Langerhans cell histiocytosis. European Respiratory Review . 2017 Sep 6 [cited 2019 Nov 21];26(145):170070

Aricò M, Girschikofsky M, Généreau T, Klersy C, McClain K, Grois N, et al. Langerhans cell histiocytosis in adultsReport from the International Registry of the Histiocyte Society. European Journal of Cancer. 2003 Nov;39(16):2341–8.

Emile JF, Abla O, Fraitag S, Horne A, Haroche J, Donadieu J, et al. Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages. Blood . 2016;127(22):2672–81

Vassallo R, Ryu JH, Schroeder DR, Decker PA, Limper AH. Clinical Outcomes of Pulmonary Langerhans’-Cell Histiocytosis in Adults. New England Journal of Medicine. 2002 Feb 14;346(7):484–90.

Tazi A, Bonay M, Bergeron A, Grandsaigne M, Hance AJ, Soler P. Role of granulocyte-macrophage colony stimulating factor (GM-CSF) in the pathogenesis of adult pulmonary histiocytosis X. Thorax . 1996 Jun;51(6):611–4.

Churg A, Tai H, Coulthard T, Wang R, Wright JL. Cigarette Smoke Drives Small Airway Remodeling by Induction of Growth Factors in the Airway Wall. American Journal of Respiratory and Critical Care Medicine . 2006 Dec 15;174(12):1327–34.

Prasse A, Stahl M, Schulz G, Kayser G, Wang L, Ask K, et al. Essential Role of Osteopontin in Smoking-Related Interstitial Lung Diseases. Am J Pathol. 2009 May 1;174(5):1683–91.

National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. PubMed. Atlanta (GA): Centers for Disease Control and Prevention (US); 2016.

Perrine CG, Pickens CM, Boehmer TK, King BA, Jones CM, DeSisto CL, et al. Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping — United States, 2019. MMWR Morbidity and Mortality Weekly Report. 2019 Oct 4;68(39):860–4.

Sansone L, Milani F, Fabrizi R, Belli M, Cristina M, Zagà V, et al. Nicotine: From Discovery to Biological Effects. International Journal of Molecular Sciences. 2023 Jan 1;24(19):14570.

Benowitz NL, Hukkanen J, Jacob P. Nicotine Chemistry, Metabolism, Kinetics and Biomarkers. Handbook of Experimental Pharmacology. 2019;192(192):29–60.

Hahn J, Monakhova YB, Hengen J, Kohl-Himmelseher M, Schüssler J, Hahn H, et al. Electronic cigarettes: overview of chemical composition and exposure estimation. Tobacco Induced Diseases. 2014 Dec;12(1).

Downloads

Published

2025-02-23

How to Cite

1.
Hirunpat B, Tanomkiat W, Kongmee I, Soonsuwon W, Setasuban W. Pulmonary Langerhans cell histiocytosis in a young adult with a history of vaping and smoking: A case report. ASEAN J Radiol [Internet]. 2025 Feb. 23 [cited 2025 Mar. 23];26(1):34-4. Available from: https://asean-journal-radiology.org/index.php/ajr/article/view/928

Issue

Section

Case Report

Most read articles by the same author(s)

1 2 3 4 > >>