Sonography of Biopsy-Proven Langerhans Cell Histiocytosis in Lymph Nodes of the Neck

Abstract

Objective. The purpose of this series is to describe the sonographic findings of lymph nodes of the neck involved by Langerhans cell histiocytosis (LCH). Methods. We reviewed and interpreted available images of lymph nodes in patients with cervical lymphadenopathies involved by LCH for the past decade. In all patients, each abnormal lymph node was pathologically confirmed by the use of a sonographically guided core needle biopsy or an incisional biopsy. Results. We characterized 3 different kinds of imaging findings for cervical lymph nodes involved by LCH: (1) a lymphomalike lesion, (2) a lesion similar to reactive lymphadenopathy, and (3) a cystic lymph node. Conclusions. There was no specific imaging finding to diagnose lymphadenopathy involved by LCH. In our study, we characterized 3 different imaging patterns of lymph node involvement by LCH. This study represents an initial step to organize specific findings for LCH. Key words: cervical lymph node; Langerhans cell histiocytosis; sonography. The clinical manifestations of LCH vary from localized to generalized and from adolescent to progressive. 3 Patients with generalized LCH have a poorer prognosis than patients with localized LCH. Cervical lymph node involvement of LCH usually occurs in patients with a known generalized form of LCH. 4,5 Fortunately, cervical lymph nodes are easy to approach for an invasive study because of their superficial location. Therefore, before an invasive study, familiarity with the imaging findings of LCH involving lymph nodes is important.

Endocrine manifestations of Langerhans cell histiocytosis diagnosed in adults

“…LCH prevalence is 1-2/1,000,000 in children and significantly lower in adults [1,[5][6][7], with no specific gender preference [5,8]. LCH may be systemic or localized [4] and its clinical manifestations are variable [2]. Systemic disease is subdivided into a high risk group, involving one or more risk organs (liver, spleen, bone marrow, and lung) and a low risk group, without involvement of risk organs [7].…”

“…Langerhans cells are immature dendritic cells of epidermis and mucosal tissues [2][3][4]. LCH prevalence is 1-2/1,000,000 in children and significantly lower in adults [1,[5][6][7], with no specific gender preference [5,8].…”

Cystic swelling in a cervical lymph node: A diagnostic dilemma

“…Cervical lymph nodes are most commonly involved, but other lymph nodes in axillary, inguinal, and supraclavicular areas can be affected . Cystic lymph nodal LCH has been rarely reported in the literature . Due to dilution of the sample by cystic change, these singly scattered atypical cells can be missed and can lead to misdiagnosis.…”