5454 Case of Diffuse Pulm...

22 yr old male smoker, presented with acute onset cough, left side chest pain & breathlessness of few days. He had polyuria & polydispia since few months. No other systemic symptoms. Chest X-ray showed left Pneumothorax & ICD tube inserted. HRCT Chest showed bilateral multiple cyst of bizarre shape of varying size, with GGO& left pneumothorax & ICD Tube in situ. FOB with BAL & TBLB was done. HPE showed Markedly thickened interstitium with infiltration by eosinophils and lymphocytes. Diffuse infiltration of large cells having granular pale eosinophilic cytoplasm,. Large cells with indistinct cytoplasmic borders, basophilic vesicular nuclei with infoldings and nuclear grooves His water deprivation test was also positive suggesting diabetes insipidus. The diagnosis of PLCH was established. Patient was given steroids & other supportive treatment. Treatment was gradually tapered & stopped.