Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children19410.24287/1726-1708-2018-17-3-74-80CLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯThe use of preventive pleurodesis in patient with Langerhans-cell histiocytosis with lung involvement: the case report and the reviewПрименение превентивного плевродеза у пациента с гистиоцитозом из клеток Лангерганса с поражением легкихhttps://orcid.org/0000-0001-8610-0624EvseevD. A.ЕвсеевД. А.
Russian Federation

Dmitry A. Evseev, MD, immunologist 

117997, Moscow, Samory Mashela st., 1

Евсеев Дмитрий Алексеевич, врач-аллерголог-иммунолог 

117997, Москва, ГСП-7, ул. Саморы Машела, 1 

dmitryevseev1991@gmail.comhttps://orcid.org/0000-0002-0813-5626KalininaI. I.КалининаИ. И.
Russian Federation
https://orcid.org/0000-0001-9424-1646UskovaN. G.УсковаН. Г.
Russian Federation
SamarinA. E.СамаринА. Е.
Russian Federation
https://orcid.org/0000-0002-7634-2053RaykinE. V.РайкинаЕ. В.
Russian Federation
https://orcid.org/0000-0002-2958-1705SalimovaT. Yu.СалимоваТ. Ю.
Russian Federation
BaydildinaD. D.БайдильдинаД. Д.
Russian Federation
https://orcid.org/0000-0001-8571-5395GoronkovaO. V.ГоронковаО. В.
Russian Federation
MitrofanovaA. M.МитрофановаА. М.
Russian Federation
https://orcid.org/0000-0003-1735-0093MaschanM. A.МасчанМ. А.
Russian Federation
https://orcid.org/0000-0002-0016-6698MaschanA. A.МасчанА. А.
Russian Federation
Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, ImmunologyФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России2409201817374802409201824092018Copyright ©; 2018, «D. Rogachev NMRCPHOI»Copyright ©; 2018, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2018«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/194

Langerhans-cell histiocytosis (LCH) is a rare myeloid neoplasia (about 3 cases per 1 000 000 children yearly). Lung involvement is rare, usually as a part of multisystem disease. Clinically these lesions manifest with signs of respiratory insufficiency like dyspnea, cough and desaturation. Imaging shows nodules that are gradually transforming into thick- or thin-walled cysts. Rapture of these cysts leads to the pneumothorax which requires drainage. Our report shows clinical case of use of elective pleurodesis to prevent life-threatening complications of histologically confirmed LCH with lung involvement, which can develop either as a result of the disease or due to chemotherapy.

Гистиоцитоз из клеток Лангерганса – редкое злокачественное новообразование (около 3 случаев на 1 000 000 детей ежегодно), развивающееся из миелоидных предшественников. Поражение легких при гистиоцитозе у детей встречается редко, обычно как часть мультисистемного поражения, и проявляется клинически признаками дыхательной недостаточности (одышка, кашель, гипоксемия), а рентгенологически – наличием узелков, постепенно трансформирующихся в толсто- и тонкостенные буллы. При прорыве таких булл развивается пневмоторакс, требующий дренирования плевральной полости. В статье представлено описание клинического случая гистологически верифицированного гистиоцитоза из клеток Лангерганса с поражением легких, в терапии которого использовали превентивный плевродез с целью предотвратить жизнеугрожающие осложнения – повторные спонтанные пневмотораксы, развитие которых сопряжено как с собственно поражением легких, так и с полихимиотерапией. 

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