Need for a cooperative study: Pulmonary Langerhans cell histiocytosis and its management in adults.
BACKGROUND
Pulmonary involvement with Langerhans cell histiocytosis (LCH, formerly known as histiocytosis-X) presents as an interstitial process in children and adults either with or without symptoms. In contrast to other manifestations of LCH, most patients with pulmonary disease are adults.


METHODS
We reviewed the literature on pulmonary LCH to determine what were the clinical presentations, prognostic variables, and treatment options for this disease.


RESULTS
Although there are spontaneous remissions, a large number of patients have progressive pulmonary deficiency and experience significant morbidity if not mortality from the disease. The efficacy of steroid versus chemotherapy in halting the process remains controversial, even if smoking is taken into consideration.


CONCLUSIONS
A multicenter study of therapy for pulmonary LCH is the obvious answer to this dilemma. We propose that interested centers organize via the Histiocyte Society to plan and execute such a trial.
McClain
Kenneth L
KL
Baylor College of Medicine and Texas Children's Cancer Center and Hematology Service, Houston, Texas 77030, USA. kmcclain@txccc.org
Gonzalez
Jorge Mario
JM
Jonkers
Rene
R
De Juli
Emanuela
E
Egeler
Maarten
M
D001847:Bone Diseases / Q000473:pathology; D003919:Diabetes Insipidus / Q000473:pathology; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008168:Lung / Q000473:pathology; D015337:Multicenter Studies as Topic / Q000592:standards; D011379:Prognosis; D012075:Remission, Spontaneous; D012307:Risk Factors; D012871:Skin Diseases / Q000473:pathology