Initial Symptoms of Langerhans Cell Histiocytosis: A Case Series

Abstract

Langerhans cell histiocytosis (LCH) is a rare childhood hematopoietic disease, and hence, there are few reports summarizing the course leading to the diagnosis. We described the initial symptoms and the clinical course of LCH. We carried out a retrospective review of charts from a single medical center, and 21 patients with the diagnosis of LCH were enrolled. The initial symptoms of 16 cases were caused by bone lesions; of these cases, there were 8 instances of soft tissue swelling as the initial symptom (38%) and 8 instances of bone pain without swelling (38%). Among the cases of bone lesion, 4 of 6 cases of skull lesion were painless while all vertebral body lesions and long bone lesions were accompanied by pain. LCH bone lesions caused various symptoms depending on the site of the lesion and this makes the diagnosis difficult. A detailed physical examination and imaging studies are recommended for early diagnosis.

Ultrasonographic analysis of Langerhans cell histiocytosis in children: a report of 55 cases

“…In one case, a mandibular lesion was misdiagnosed as mumps, thereby delaying treatment. 18 Ultrasonography of LCH-affected flat bones mainly shows punched-out osteolytic bone destruction, and the inner and outer plates of the skull become separated, with the outer plate markedly damaged and the inner plate less severely damaged. The bone exhibits uneven osteolytic destruction that is trumpet- or ladder-shaped.…”

Histiocitosis de células de Langerhans: reporte de caso y revisión de la literatura

“…El sistema más comúnmente afectado es el óseo (80 %), principalmente los huesos del cráneo, seguidos por los huesos largos y las vértebras 17 , 18 ) . El compromiso de la piel puede verse hasta en una tercera parte de los pacientes y afecta con mayor frecuencia las áreas intertriginosas.…”

Langerhans Cell Histiocytosis in a Three-Year-Old Girl in Bosnia and Herzegovina

“…The most commonly affected organ in LCH is bone, where changes are present in 80% of cases (61% in the skull). It manifests as a tumor mass, sometimes accompanied by pain and swelling (6,7). The time from the onset of bone lesion symptoms to the diagnosis of LCH varies, ranging from 1.5 to 4 months, according to a study in Japan.…”