Liver TransplantationRecurrence of langerhans cell histiocytosis in the graft after liver transplantation in adults
Section snippets
Case report
A 28-year-old man affected by LCH, who had a past history of spontaneous pneumothorax, was admitted for hepatic transplantation for end-stage liver disease. Four years before the liver transplant, liver and lung biopsies revealed the diagnosis of multisystem LCH. The liver biopsy showed edema of the portal tracts with an active chronic inflammatory cell infiltrate that included eosinophils. An endoscopic cholangiogram showed dilated intrahepatic ducts with intraluminal filling defects. Chest
Discussion
Liver involvement occurs in 20% to 35% of LCH cases,1, 3, 7 affecting children <2 years of age most often. The histologic appearance of the liver shows varying grades of bile duct proliferation, portal tract inflammation, fibrohistiocytic proliferation, granulomas, and portal cirrhosis.3, 14 Liver injury in LCH may be caused by histiocytic infiltration with intrahepatic and extrahepatic biliary obstructions as well as extrinsic compression of the common bile duct by adenopathy in the hepatic
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