Medical case history 80-year-old man, current smoker (60 p/y)

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Presentation transcript:

Medical case history 80-year-old man, current smoker (60 p/y) Former office worker No family history of chronic lung diseases He denies occupational/environmental exposures PMH: chronic heart failure (pace-maker carrier), type II diabetes, hypercholesterolemia Medications: no potentially pneumotoxic drugs HPI: slowly progressive exertional dyspnoea for the last 9 months. No constitutional signs/symptoms PFT: FVC 101%, FEV1 106%, FEV1/FVC 78%,TLC 93%, DLCO 88% PMH: past medical history HPI: history of the present illness

Bronchoscopy: negative BAL: normal Transbronchial biopsy: not diagnostic

Management Clinico-radiological follow-up Smoking cessation Yet, worsening lung function FVC: 98% FEV1: 111% FEV1/FVC: 83% TLC: 92% DLCO: 38%

Management/outcome Palliative radiotherapy for his lung cancer He died 18 months later

Bronchogenic Carcinoma in Patients with Pulmonary Histiocytosis X Danielle Sadoun, Fabien Vaylet, Dominique Valeyre et al. 1992

Subacute HP Respiratry Bronchiolitis Welder’s Lung