[Thoracoscopy in pulmonary histiocytosis X]

We report 4 cases of recurrent multiple pneumothorax in patients with diffuse interstitial lung disease diagnosed as histiocytosis X. These cases demonstrate the dual value of thoracoscopy in that disease: (1) it facilitates the diagnosis by showing the characteristic macroscopic aspect of the lung with multiple blebs and by enabling pulmonary biopsies to be performed; (2) it contributes to the treatment and prevention of pneumothorax by diffuse pleural poudrage. Immediate thoracoscopy should therefore be contemplated in special conditions, such as pulmonary interstitial lung disease with pneumothorax as first presentation.