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Eosinophilic Granuloma (Histiocytosis X) Differential Diagnoses

  • Author: Eleanor M Summerhill, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
 
Updated: Jun 03, 2016
 
 

Diagnostic Considerations

Other possible diagnoses include the following:

  • Lymphangioleiomyomatosis (LAM): Patients with pulmonary Langerhans cell histiocytosis X (PLCH) frequently present to medical attention with spontaneous pneumothoraces. Lymphangioleiomyomatosis is a disorder that exclusively affects young women and is characterized by cystic, emphysematous dilation of the terminal airways and shares this predisposition. It may be mistaken for PLCH on a chest radiograph or high-resolution CT (HRCT) scan of the chest.
  • Pulmonary histiocytic sarcoma[10]

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Eleanor M Summerhill, MD, FACP, FCCP Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Warren Alpert Medical School of Brown University; Director, Internal Medicine Residency Program, Memorial Hospital of Rhode Island

Eleanor M Summerhill, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Thoracic Society, Rhode Island Medical Society, Association of Program Directors in Internal Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Daniel R Ouellette, MD, FCCP Associate Professor of Medicine, Wayne State University School of Medicine; Chair of the Clinical Competency Committee, Pulmonary and Critical Care Fellowship Program, Senior Staff and Attending Physician, Division of Pulmonary and Critical Care Medicine, Henry Ford Health System; Chair, Guideline Oversight Committee, American College of Chest Physicians

Daniel R Ouellette, MD, FCCP is a member of the following medical societies: American College of Chest Physicians, Society of Critical Care Medicine, American Thoracic Society

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, FACP, FCCP Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Michael Peterson, MD Chief of Medicine, Vice-Chair of Medicine, University of California, San Francisco, School of Medicine; Endowed Professor of Medicine, University of California, San Francisco-Fresno, School of Medicine

Michael Peterson, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Thoracic Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Robert S. Crausman, MD, MMS, to the development and writing of this article.

References
  1. Podbielski FJ, Worley TA, Korn JM, Connolly MM. Eosinophilic granuloma of the lung and rib. Asian Cardiovasc Thorac Ann. 2009 Apr. 17(2):194-5. [Medline].

  2. Szturz P, Rehak Z, Koukalova R, Adam Z, Mayer J. FDG-PET positive pilomatrixoma--reconsidering multicentricity in Langerhans cell histiocytosis. Nucl Med Rev Cent East Eur. 2014. 17(2):94-6. [Medline].

  3. Gaensler EA, Carrington CB. Open biopsy for chronic diffuse infiltrative lung disease: clinical, roentgenographic, and physiological correlations in 502 patients. Ann Thorac Surg. 1980 Nov. 30(5):411-26. [Medline].

  4. Colby TV, Lombard C. Histiocytosis X in the lung. Hum Pathol. 1983 Oct. 14(10):847-56. [Medline].

  5. Thomeer M, Demedts M, Vandeurzen K. Registration of interstitial lung diseases by 20 centres of respiratory medicine in Flanders. Acta Clin Belg. 2001 May-Jun. 56(3):163-72. [Medline].

  6. Watanabe R, Tatsumi K, Hashimoto S, Tamakoshi A, Kuriyama T. Clinico-epidemiological features of pulmonary histiocytosis X. Intern Med. 2001 Oct. 40(10):998-1003. [Medline].

  7. Vassallo R, Ryu JH, Schroeder DR, Decker PA, Limper AH. Clinical outcomes of pulmonary Langerhans'-cell histiocytosis in adults. N Engl J Med. 2002 Feb 14. 346(7):484-90. [Medline].

  8. Delobbe A, Durieu J, Duhamel A, Wallaert B. Determinants of survival in pulmonary Langerhans' cell granulomatosis (histiocytosis X). Groupe d'Etude en Pathologie Interstitielle de la Société de Pathologie Thoracique du Nord. Eur Respir J. 1996 Oct. 9(10):2002-6. [Medline].

  9. DiCaprio MR, Roberts TT. Diagnosis and Management of Langerhans Cell Histiocytosis. J Am Acad Orthop Surg. 2014 Oct. 22(10):643-652. [Medline].

  10. Stacher E, Beham-Schmid C, Terpe HJ, Simiantonaki N, Popper HH. Pulmonary histiocytic sarcoma mimicking pulmonary Langerhans cell histiocytosis in a young adult presenting with spontaneous pneumothorax: a potential diagnostic pitfall. Virchows Arch. 2009 Aug. 455(2):187-90. [Medline].

  11. Alalawi R, Whelan T, Bajwa RS, Hodges TN. Lung transplantation and interstitial lung disease. Curr Opin Pulm Med. 2005 Sep. 11(5):461-6. [Medline].

  12. Misaki H, Yamauchi T, Arai H, et al. Secondary malignant fibrous histiocytoma following refractory langerhans cell histiocytosis. J Clin Exp Hematop. 2009 May. 49(1):33-7. [Medline].

  13. Harari S, Torre O, King Jr TE, Moss J. Pulmonary Langerhans' Cell Histiocytosis. Elias JA, Fishman JA, Kotloff RM, Pack A, Senior RM, eds. Fishman's Pulmonary Diseases and Disorders. 5th ed. New York, NY: McGraw-Hill; 2015. 919-27.

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Low-power photomicrograph of a lung-tissue specimen that demonstrates the classic stellate nodule of pulmonary histiocytosis X (hematoxylin-eosin stain).
 
 
 
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