Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report.
Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Yeun Seoung
YS
Choi
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jung Soo
JS
Lim
Department of Radiology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Woocheol
W
Kwon
Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Soon-Hee
SH
Jung
Department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
Il Hwan
IH
Park
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Myoung Kyu
MK
Lee
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Won Yeon
WY
Lee
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Suk Joong
SJ
Yong
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Seok Jeong
SJ
Lee
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ye-Ryung
YR
Jung
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jiwon
J
Choi
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Ji Sun
JS
Choi
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Joon Taek
JT
Jeong
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jin Sae
JS
Yoo
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Sang-Ha
SH
Kim
Cystic Disease of Lung; Diabetes Insipidus; Diabetes Mellitus; Histiocytosis, Langerhans-Cell; Smoking Cessation