53-year-old female with nicotine dependence presents with dyspnea and cough

CXR shows diffuse interstitial reticulonodular changes

LANGERHANS HISTIOCYTOSIS
53-year-old female with nicotine dependence presents with dyspnea and cough
CXR (PA and Lateral) shows bilateral and extensive reticular nodular changes slightly more prominent in the upper lung zones Ashley Davidoff MD

CT scan from 16 months prior showed multiple relatively thick-walled cysts predominantly in the upper lobes. The cysts are round and air filled large and are between 5mm-8mm

CT  CORONAL VIEW – UPPER ZONES MORE AFFECTED THAN LOWER LUNG ZONES – LANGERHANS HISTIOCYTOSIS 
Ashley Davidoff MD
CT  CORONAL VIEW – UPPER ZONES MORE AFFECTED THAN LOWER LUNG ZONES – LANGERHANS HISTIOCYTOSIS
Ashley Davidoff MD
CT AXIAL VIEW –   APEX SHOWS MOST SEVERE DISEASE

Ashley Davidoff MD

CT HILAT REGIONS – LANGERHANS HISTIOCYTOSIS
Ashley Davidoff MD
CT BASAL REGIONS – LANGERHANS HISTIOCYTOSIS
Ashley Davidoff MD

CORONAL RECONSTRUCTION OF CT 9 MONTHS LATER – -IMPROVED
CT scan 9 months later shows improvement in the thickened walls of the cysts but maintenance of diffuse cystic changes predominantly in the upper lobes
Ashley Davidoff MD

2 YEARS LATER

CORONAL RECONSTRUCTION OF CT 2 YRS LATER – UPPER LOBE DOMINANCE -IMPROVED
A CT scan done 2 years later shows no significant change in the diffuse bilateral cystic changes, dominant in the upper lobes and consistent with Langerhans histiocytosis
Ashley Davidoff MD
CORONAL RECONSTRUCTION OF CT 2 YRS LATER -IMPROVED
– UPPER LOBE DOMINANCE
Ashley Davidoff MD
IMPROVED CT AXIAL VIEW  APEX SHOWS MOST SEVERE DISEASE
LANGERHANS HISTIOCYTOSIS
Ashley Davidoff MD
IMPROVED CT HILAR REGIONS – LANGERHANS HISTIOCYTOSIS
Ashley Davidoff MD
IMPROVED CT LOWER LUNG ZONES
LANGERHANS HISTIOCYTOSIS
53-year-old female with nicotine dependence presents with dyspnea and cough
CXR (PA and Lateral) shows bilateral and extensive reticular nodular changes slightly more prominent in the upper lung zones
CT scan from 16 months prior showed multiple relatively thick-walled cysts predominantly in the upper lobes. The cysts are round and air filled large and are between 5mm-8mm
CT scan 9 months later shows improvement in the thickened walls of the cysts but maintenance of diffuse cystic changes predominantly in the upper lobes
A CT scan done 2 years later shows no significant change in the diffuse bilateral cystic changes, dominant in the upper lobes and consistent with Langerhans histiocytosis
Ashley Davidoff MD

 

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