Multifocal Skeletal Tuberculosis Mimicking Langerhans Cell Histiocytosis in a Child: a Case Report With a Long-Term Follow-Up

Aims To analyze the radiologic characteristics, clinical course and long-term follow-up of 7 radiologically uncommon pediatric cases of Langerhans cell histiocytosis and to identify prognostic factors related to imaging patterns. Methods The clinical records and complete imaging data of 75 patients with LCH diagnosed and treated at the National Cancer Institute of Milan between January 1975 and December 1993 were analyzed, and 43 cases presenting as unifocal bone lesions were identified. The plain film, computed tomography and magnetic resonance characteristics enabled the identification of 7 radiologically aggressive and rapidly progressive cases, which were analyzed at presentation and during follow-up. Results Although at disease presentation bone lesions appeared lytic destructive, rapidly progressive and often involved adjacent soft tissues, after adequate therapy the disease course was invariably benign and led to almost complete restoration of normal structure and function. Long-term follow-up confirmed the favorable outcome and lack of disease recurrence in all cases. Conclusions There is no correlation between radiologically aggressive characteristics and final outcome in Langerhans cell histiocytosis. Radiologists and pediatric oncologists should be acquainted with less common radiologic forms which, at presentation, can mimic more ominous diseases. If recognized and adequately treated, monostotic forms almost invariably have a benign prognosis.

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Rare Case of Adult Langerhans Cell Histiocytosis: A Case Report

Indonesian Journal of Cancer ◽

10.33371/ijoc.v13i1.618 ◽

2019 ◽

Vol 13 (1) ◽

pp. 17

Author(s):

Dinny Gustina Prihadi ◽

Agung Firmansyah Sumantri ◽

Hasyarati Agustina ◽

Indra Wijaya

Keyword(s):

Case Report ◽

Langerhans Cell Histiocytosis ◽

Rare Case ◽

Malignant Tumors ◽

Corticosteroid Injection ◽

Langerhans Cell ◽

Intralesional Corticosteroid ◽

Adult Male Patient

Background: Langerhans Cell Histiocytosis (LCH) is a disease characterized by proliferation and infiltration of histiocytes in various organs that is caused by local or systemic effects. LCH could affect bones, lungs, central nervous system, liver, thymus, skin, and lymph nodes. The diagnosis of LCH is difficult to enforce and rarely found in adults, namely 1-2 cases per million per year.Case Presentation: In Indonesia, there were very few cases of LCH in adults, one of which was found in women aged 56 years. LCH does not yet have standard treatments. The treatment is given based on location and severity, including intralesional corticosteroid injection, radiotherapy, surgical or excision curettage, and chemotherapy. Prednisone and vinblastine chemotherapy was one of chemotherapy that is given to LCH patients. Prognosis of LCH consists of various factors, one of which is the number of organs involved. This is a case report of LCH in an adult male patient with skin involvement who received chemotherapy for 6 weeks and experienced improvement.Conclusions: LCH is not only a disease of children; it is also reported in an adult. The prognosis is related to the number of organ involved and involvement of the risk organ. LCH can recur easily and accompany malignant tumors, so follow-up and long-term observations are still needed to be done.

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