A 17 year old female was seen because of a non‐productive cough and one episode of blood‐tinged sputum. A computerized tomography (CT) scan of the chest showed multiple small cystic lucencies in the upper lobes. The mediastinal CT window revealed concurrent mediastinal lymphadenopathy. An open lung biopsy showed Langerhans' cell histiocytosis (LCH). The significance of nodal involvement in LCH of the lung is not known, but raises the possibility of regional LCH and warrants a further search for bone or visceral involvement as well as closer follow‐up and monitoring of pat
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