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Query: UMLS:C0019621 (Langerhans cell histiocytosis)
 3,250 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Localized Langerhans cell histiocytosis (LCH) of bone often presents as a diagnostic challenge. Magnetic resonance imaging (MRI) is frequently used to better delineate most solitary bony lesions. The authors present two cases that illustrate and better define the role of MRI in the evaluation of solitary bone lesions of LCH. In a 3-year-old boy with left-sided hip pain, MRI showed a focal lesion involving the proximal left femur with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. A tumor was suspected because of the overall imaging characteristics and increased uptake on three-phase nuclear scintigraphy. In a 6-year-old boy with right thigh pain, MRI showed a fluid-containing lesion in the mid-diaphysis of the right femur, suggestive of chronic osteomyelitis and Brodie abscess. MRI was instrumental in showing the extent of the lesions in both cases; however, the final diagnosis of LCH was achieved only with histopathologic confirmation, illustrating the limited diagnostic power of this imaging tool.
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PMID:Defining the role of magnetic resonance imaging in unifocal bone lesions of langerhans cell histiocytosis. 1609 26

This article presents 2 uncommon cases of Langerhans cell histiocytosis of the acetabulum in adults. Langerhans cell histiocytosis is a benign lesion of bone with a diversity of radiographic appearances depending on location. Radiographs of our cases showed a clearly defined radiolucent area at the acetabulum. Magnetic resonance imaging revealed specific findings for Langerhans cell histiocytosis of the acetabulum. Gadolinium-enhanced images showed that abnormal signal was spread to the whole acetabulum surrounding the lesion. Orthopedic surgeons should be aware of the existence of this lesion and attentive to patients who report spontaneous hip pain, although Langerhans cell histiocytosis is a rare condition in adults. It is generally agreed that prognosis is more dependent on age at the time of diagnosis rather than on therapy. We recommend simple curettage for Langerhans cell histiocytosis of the acetabulum in adults to obtain a definite diagnosis and relieve pain.
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PMID:Langerhans cell histiocytosis of the acetabulum in adults. 1938 4

Langerhans cell histiocytosis (LCH) is rare in adults. Regular follow-up is mandatory due to reoccurrence. A 35-year-old male with an incidental left iliac bone lesion was diagnosed with LCH. He later became symptomatic with hip pain and spread of the disease. Despite excision of the symptomatic iliac lesion, he had progression while on cytarabine and nivolumab, evidenced by increased bone pain and involvement of other bones on imaging. He underwent excision of the jaw lesion followed by vinblastine; he was pain free and had stable disease on PET imaging after 3 months. LCH is an uncommon neoplasia. Treatment is reserved for symptomatic patients while asymptomatic patients are observed. Follow-up is imperative due to the risk of reoccurrence. Despite surgical treatment together with one of the front-line agents for refractory disease, in this case cytarabine, he still had progression of the disease. Furthermore, the trial of nivolumab was of no benefit. This case highlights good response to vinblastine which is previously reported to have good success. No trials are published, and the optimal strategy has yet to be defined. LCH with multiple bony involvement can be aggressive and therapeutically challenging.
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PMID:An Aggressive Form of Langerhan Cell Histiocytosis in an Adult: Therapeutic Challenges. 2952 66

Initial extranodal osseous presentation of Classic Hodgkin lymphoma (CHL) is extremely rare. The present study describes a case of CHL in an 11-year-old male presenting with lower back and right hip pain. Radiologic imaging showed a solitary lytic lesion involving the L5 vertebrae and sacrum. Pathologic examination led to a diagnosis of extranodal osseous CHL and further workup proved bone marrow and nodal disease. Diagnosis of extranodal osseous CHL is challenging, especially in this age group and location. When confronted with a solitary lytic bone lesion in a young patient, more common benign and neoplastic entities enter the differential diagnosis and include osteomyelitis, Langerhans cell histiocytosis, epithelioid hemangioma of bone, leukemia, and anaplastic large cell lymphoma (ALCL) among others, with extranodal osseous CHL being one of the less common entities in the differential diagnosis. This case report raises the awareness of extranodal osseous CHL as one of the entities to consider when confronted with a solitary lytic bone lesion in a young patient.
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PMID:Classic Hodgkin lymphoma with initial extranodal osseous presentation: a case report and literature review. 3146 27