Pulmonary crystal-storing histiocytoma in a patient without a lymphoproliferative disorder

Am J Med Sci. 2009 Nov;338(5):421-4. doi: 10.1097/MAJ.0b013e3181ad3feb.

Abstract

Pulmonary crystal-storing histiocytoma is a very rare disorder and is characterized by infiltration of histiocytes with intracytoplasmic accumulation of crystallized immunoglobulins. It is usually associated with lymphoproliferative diseases or plasma cell dyscrasia. Here, we report a case of pulmonary crystal-storing histiocytoma in a 64-year-old man, presenting as a chronic pulmonary consolidation in the lung exposed to asbestos. Video-assisted thoracoscopic surgical biopsy displayed sheets of large, epithelioid histiocytes filled with a large number of needle-like crystals, showing the accumulation of crystallized polyclonal immunoglobulins. This lesion was consistent with crystal-storing histiocytosis or crystal-storing histiocytoma. With extensive clinical work-up, the current case was not associated with lymphoproliferative diseases. Herein, we present this extremely rare entity of pulmonary pathology, a pulmonary crystal-storing histiocytoma arising in the lung exposed to asbestos, and demonstrate the clinical, radiologic, and pathologic features of the tumor.

Publication types

  • Case Reports

MeSH terms

  • Asbestos / toxicity*
  • Crystallization
  • Diagnosis, Differential
  • Histiocytes / chemistry
  • Histiocytes / pathology
  • Histiocytes / ultrastructure
  • Histiocytoma / chemically induced*
  • Histiocytoma / diagnosis*
  • Histiocytoma / diagnostic imaging
  • Histiocytoma / pathology
  • Humans
  • Immunoglobulin A / chemistry
  • Immunoglobulin A / ultrastructure
  • Immunoglobulin G / chemistry
  • Immunoglobulin G / ultrastructure
  • Lung Neoplasms / chemically induced*
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lymphoproliferative Disorders / diagnosis
  • Male
  • Middle Aged
  • Occupational Exposure / adverse effects*
  • Radiography
  • Thoracic Surgery, Video-Assisted

Substances

  • Immunoglobulin A
  • Immunoglobulin G
  • Asbestos