Histiocitosis de células de Langerhans, una afección pulmonar infradiagnosticada en fumadores: reporte de caso y revisión de la literatura

  • Diana Lizeth Cabrera-Rojas Universidad de Antioquia
  • Gustavo Adolfo Gómez-Correa Hospital Universitario San Vicente Fundación, Universidad de Antioquia
  • Gabriel Jaime Varela-Aguirre Hospital Universitario San Vicente Fundación, Hospital Pablo Tobón Uribe, Clínica Aurora Centro Especializado en Cáncer de Piel, Universidad Pontificia Bolivariana https://orcid.org/0000-0002-6607-5940
Palabras clave: histiocitosis de células de Langerhans, nódulos, pulmón, quistes, tabaquismo, histopatología, inmunohistoquímica.

Resumen

La histiocitosis de células de Langerhans (HCL) es una enfermedad que puede afectar a pacientes de cualquier edad, siendo en adultos un trastorno poco común de etiología desconocida, que ocurre predominantemente en fumadores jóvenes, sin diferencias en género. Aunque ciertas particularidades de la enfermedad pueden compartirse con las manifestaciones presentes en la población pediátrica, la proporción de casos con afectación pulmonar es mucho mayor en adultos. A menudo evoluciona a través de brotes sucesivos y su gravedad varía desde formas benignas hasta potencialmente mortales. Algunos pacientes desarrollan un importante deterioro funcional con repercusión psicosocial, que impacta en la calidad de vida y se asocia a discapacidad prolongada. La clave diagnóstica estará determinada por el antecedente de tabaquismo, la presencia de nódulos, nódulos cavitados y quistes de paredes gruesas y delgadas en la tomografía computarizada de tórax de alta resolución (TACAR). Sin embargo, el diagnóstico definitivo requiere la identificación de granulomas de células de Langerhans, que generalmente se logra mediante la realización de una biopsia pulmonar y su estudio histopatológico e inmunohistoquímico. En la actualidad, podríamos considerar a esta entidad como una enfermedad huérfana, de la cual aún no se tiene claridad del mecanismo patogénico, y que, por ende, aún no dispone de estrategias terapéuticasespecíficas. El objetivo de esta revisión está centrado en la aproximación diagnóstica y terapéutica de la histiocitosis de células de Langerhans en adultos,que permita facilitar su reconocimiento en etapas tempranas y mejorar el pronóstico en las personas que la padecen.

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Biografía del autor/a

Diana Lizeth Cabrera-Rojas, Universidad de Antioquia

Médica, Residente de Toxicología Clínica, Facultad de Medicina, Universidad de Antioquia. Medellín, Colombia.

Gustavo Adolfo Gómez-Correa, Hospital Universitario San Vicente Fundación, Universidad de Antioquia

Médico, Especialista en Medicina Interna y Neumología, Clínica CES, Instituto del Tórax, Hospital Universitario San Vicente Fundación, Sección de Neumología, Universidad de Antioquia. Medellín, Colombia.

Gabriel Jaime Varela-Aguirre, Hospital Universitario San Vicente Fundación, Hospital Pablo Tobón Uribe, Clínica Aurora Centro Especializado en Cáncer de Piel, Universidad Pontificia Bolivariana

Médico, Especialista en Patología Oncológica y Dermopatología, Laboratorio de Patología Oncológica, Hospital Universitario San Vicente Fundación, Hospital Pablo Tobón Uribe, Clínica Aurora Centro Especializado en Cáncer de Piel, Universidad Pontificia Bolivariana. Medellín, Colombia. https://orcid.org/0000-0002-6607-5940.

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Cómo citar
1.
Cabrera-Rojas DL, Gómez-Correa GA, Varela-Aguirre GJ. Histiocitosis de células de Langerhans, una afección pulmonar infradiagnosticada en fumadores: reporte de caso y revisión de la literatura. Med. Lab. [Internet]. 1 de octubre de 2021 [citado 26 de octubre de 2021];25(4):721-34. Disponible en: https://medicinaylaboratorio.com/index.php/myl/article/view/526
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2021-10-01
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