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September 1968

Gastrointestinal Bleeding From Ileal Ulcerations in Histiocytosis X

Author Affiliations

Los Angeles

From the Department of Medicine, Division of Gastroenterology, The Center for the Health Sciences, University of California, Los Angeles.

Arch Intern Med. 1968;122(3):271-272. doi:10.1001/archinte.1968.00300080079015

In 1953 Lichtenstein 1 suggested the term histiocytosis X for the group of reticuloendothelioses which have the common pathological feature of tissue infiltration by histiocytes. Only occasionally has gastrointestinal involvement in disseminated histiocytosis X of the Hand-Schüller-Christian or Letterer-Siwe varieties been reported 2-5 and in none of these cases was significant gastrointestinal bleeding observed. In the case reported below, one of the most prominent clinical manifestations was prolonged and severe gastrointestinal bleeding which at autopsy was found to be due to multiple ileal ulcerations.

Patient Summary  A 64-year-old white man was in good health until March 1963, when he developed dry cough, fever, night sweats, weakness, anorexia, and then dyspnea on exertion over a two-week period. A chest x-ray film showed a diffuse, coarse interstitial pulmonary infiltrate producing a "honeycomb" appearance. Biopsy diagnosis from an enlarged supraclavicular lymph node was histiocytosis X, Hand-Schüller-Christian variant (Fig 1). Stains and cultures for