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July 1980

Pleural Effusion in Histiocytosis X

Arch Intern Med. 1980;140(7):988. doi:10.1001/archinte.1980.00040020988031

To the Editor.—  We have read with interest the article by Guardia et al, in the Archives, entitled "Early Pleural Effusion in Histiocytosis X" (139:934-936,1979). We had a similar case with recurrent pleural effusion, which turned our attention to a different aspect of the effusion.

Report of a Case.—  A 59-year-old man with adult-onset diabetes mellitus was first seen in January 1974, with nonketotic hyperosmolar coma and diabetes insipidus of undetermined cause. In March 1976, he had chronic otitis media and recurrent ulcerative lesions of the buccal mucosa. Biopsy of the lesions disclosed typical histopathologic changes of histiocytosis X. Hepatomegaly and multiple bone lesions involving the lower extremities, pelvis, and right frontoparietal area of the skull were noted. Chest roentgenograms were normal. A bone marrow biopsy specimen was compatible with histiocytosis X. In March 1978, the patient manifested increasing shortness of breath, pedal edema, and proptosis of the right eye. Chest roentgenograms showed cardiomegaly and bilateral