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Introduction: Pulmonary Langerhans cell histiocytosis X (PLCHx) is a rare interstitial lung disease of unknown aetiology and occurs mostly in young smokers. Lung involvement alone accounts for >85% of the cases; other organs may be involved too (5%-15%). Case report: A 19-year-old boy was presented to the emergency service with sudden-onset, sharp, stabbing chest pain and dyspnoea. The patient had no history of smoking. His medical and family histories were negative for any disease. Thoracic radiography showed increased reticulonodular density with a near-total bilateral pneumothorax at the left and partially at the right. Hence, bilateral tube thoracostomy was performed. High-resolution computed tomography (HRCT) showed pronounced thin-walled cystic structures smaller than 10 mm and small millimetre-sized nodules in the upper and middle zones. Extrapulmonary Langerhans cell histiocytosis was excluded based on the radiological and laboratory findings. Based on the clinical and tomography findings, diagnosis of PLCHx was made. Conclusion: Our case highlights that PLCHx should be suspected in non-smokers. Further studies elucidating the aetiology of PLCHx are needed. [ABSTRACT FROM AUTHOR]