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Pulmonary manifestations of Erdheim–Chester disease: clinical characteristics, outcomes and comparison with Langerhans cell histiocytosis
Author(s) -
Wang Jinuo,
Wang Fengdan,
Sun Jian,
Liang Zhiyong,
Li Jian,
Zhou Daobin,
Tian Xinlun,
Cao Xinxin
Publication year - 2021
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.17712
Subject(s) - medicine , histiocytosis , langerhans cell histiocytosis , interstitial lung disease , pneumothorax , lung , erdheim–chester disease , respiratory disease , retrospective cohort study , radiology , gastroenterology , pathology , disease
Summary Erdheim–Chester disease (ECD) is a rare form of non‐Langerhans cell histiocytosis that typically affects many organs, including the lung and pleura. However, there are few studies concerning pulmonary involvement in ECD patients, as well as the difference of pulmonary involvement between ECD and Langerhans cell histiocytosis (LCH). We performed a retrospective study of 54 ECD patients, and compared the pulmonary manifestations with those of adult LCH patients in our centre. The median age of diagnosis of the 54 ECD patients was 48 years (range 9–66 years). Chest computed tomography (CT) scans revealed lung involvement in 49 (91%) patients and pleural involvement in 34 (63%). Thirty‐three (61%) patients had interstitial lung disease (ILD) with varying degrees of interlobular septal thickening, micronodules, and ground‐glass opacities. ECD and LCH patients with pulmonary involvement showed significant differences in smoking status ( P < 0·001), respiratory symptoms ( P = 0·001) such as cough and pneumothorax ( P < 0·001), and radiological findings, including cysts ( P < 0·001), opacities ( P < 0·001), and pleural thickening ( P < 0·001). With a median follow‐up duration of 24 months (range, 1–84 months), the estimated three‐year overall survival (OS) of this entire ECD cohort was 90·2%. Patients with ILD tended to have worse progression‐free survival (PFS) than those with no ILD ( P = 0·29).