Vojnosanitetski pregled 2013 Volume 70, Issue 12, Pages: 1159-1161
https://doi.org/10.2298/VSP1312159L
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Multisystem Langerhans cell histiocytosis coexisting with metastasizing adenocarcinoma of the lung: A case report
Lovrenski Aleksandra 
(Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica + Faculty of Medicine, Novi Sad)
Đurić Mirna (Faculty of Medicine, Novi Sad + Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pulmology, Sremska Kamenica)
Klem Ištvan (Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica + Faculty of Medicine, Novi Sad)
Eri Živka (Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica + Faculty of Medicine, Novi Sad)
Panjković Milana (Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica + Faculty of Medicine, Novi Sad)
Tegeltija Dragana (Institute for Pulmonary Diseases of Vojvodina, Center for Pathology, Sremska Kamenica + Faculty of Medicine, Novi Sad)
Považan Đorđe (Faculty of Medicine, Novi Sad + Institute for Pulmonary Diseases of Vojvodina, Clinic for General Pulmology, Sremska Kamenica)
Introduction. Langerhans cell histiocytosis (LCH) is an uncommon disease of
unknown etiology characterized by uncontrolled proliferation and infiltration
of various organs by Langerhans cells. Case report. We presented a
54-year-old man, heavy smoker, with dyspnea, cough, hemoptysis, headache and
ataxia, who died shortly after admission to our hospital. On the autopsy,
tumor was found in the posterior segment of the right upper pulmonary lobe as
well as a right-sided occipitoparietal lesion which penetrated into the right
ventricle resulting in internal and external hematocephalus. Histologically
and immunohistohemically, the diagnosis of primary lung adenocarcinoma with
brain metastasis was made (tumor cells showed positivity for CK7 and TTF-1
which confirmed the diagnosis). In the lung parenchyma around the tumor, as
well as in brain tissue around the metastatic adenocarcinoma histiocytic
lesions were found. Light microscopic examination of the other organs also
showed histiocytic lesions involving the pituitary gland, hypothalamus,
spleen and mediastinal lymph nodes. Immunohistochemical studies revealed
CD68, S-100 and CD1a immunoreactivity within the histiocytes upon which the
diagnosis of Langerhans' cells histiocytosis was made. Conclusion. The
multisystem form of LCH with extensive organ involvement was an incidental
finding, while metastatic lung adenocarcinoma to the brain that led to
hematocephalus was the cause of death.
Keywords: histiocytosis, langerhans-cell, diagnosis, lungneoplasms, adenocarcinoma, immunohistochemistry