肺朗格汉斯细胞组织细胞增多症与肺结核的鉴别诊断（附一例报告）

Case report： differential diagnosis of pulmonary Langerhans cell histiocytosis and pulmonary tuberculosis

肺郎格汉斯细胞组织细胞增多症（pulmonary Langerhans cell histiocytosis，PLCH）是一种少见的肺间质疾病，可原发于肺，也可能是全身LCH系统性病变的局部表现。肺组织病理表现以朗格汉斯细胞增生和浸润为特征，形成双肺多发的细支气管旁间质结节和囊腔。其早期影像特点易与肺结核相混淆。笔者就大连市结核病医院于2015年4月29日收治的1例胸部CT扫描显示以上中肺野小结节改变为主的PLCH病例，与本院专家进行临床讨论，以提高临床医生对PLCH与肺结核的诊断和鉴别诊断的能力。

Pulmonary Langerhans cell histiocytosis （PLCH） is a rare pulmonary interstitial disease, lung could be both primary or iust local lesion of systemic LCH disease. Pathology of the lung is proliferation and infiltration of Langerhans cells, which form multiple interstitial nodules and cysts near the bronchioles. The imaging features of PLCH at early stage are easily confused with the phthisis. There is a case of PLCH with middle-upper lung nodules in Chest CT hospitalized in Dalian Tuberculosis Hospital on April 29, 2015. The discussion among specialists from Dalian Tuberculosis Hospital could help clinicians in diagnosis and differential diagnosis of Langerhans cell histiocytosis and pulmonary tuberculosis.