Zhang ZR, Chen F, Chen HJ. Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report. World J Radiol 2024; 16(6): 232-240 [PMID: 38983837 DOI: 10.4329/wjr.v16.i6.232]
Corresponding Author of This Article
Feng Chen, Doctor, MD, Doctor, Professor, Department of Radiology, The Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China.fenger0802@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jun 28, 2024; 16(6): 232-240 Published online Jun 28, 2024. doi: 10.4329/wjr.v16.i6.232
Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report
Zhan-Rong Zhang, Feng Chen, Hui-Juan Chen
Zhan-Rong Zhang, Feng Chen, Hui-Juan Chen, Department of Radiology, The Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), Haikou 570311, Hainan Province, China
Author contributions: Chen F and Chen HJ conducted quality control on the patient’s examination report; Zhang ZR collected and compiled the case data and wrote the manuscript; Chen F and Chen HJ reviewed and revised the manuscript; All authors read and approved the final manuscript.
Supported byHainan Academician Innovation Platform Fund, and the Hainan Province Clinical Medical Center.
Informed consent statement: Informed written consent was obtained from the patient’s family for publication of this anonymized report and any accompanying images.
Conflict-of-interest statement: All authors declare having no competing financial interests for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Chen, Doctor, MD, Doctor, Professor, Department of Radiology, The Affiliated Hainan Hospital of Hainan Medical University (Hainan General Hospital), No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China.fenger0802@163.com
Received: January 17, 2024 Revised: April 29, 2024 Accepted: May 17, 2024 Published online: June 28, 2024 Processing time: 160 Days and 19.2 Hours
Abstract
BACKGROUND
Langerhans cell histiocytosis (LCH) is characterized by diabetes insipidus and is an uncommon occurrence. Pathological biopsies still have a certain degree of diagnostic probability. We present a case in which LCH initially affected the pituitary gland. This resulted in a misdiagnosis of chronic inflammation upon pathological examination.
CASE SUMMARY
A 25-year-old female exhibited symptoms of diabetes insipidus. Magnetic resonance imaging revealed an enhanced foci in the pituitary gland. After surgical resection of the pituitary lesion, the pathological diagnosis was chronic inflammation. However, the patient later experienced bone destruction in the skull and lower limb bones. After the lower limb bone lesion was compared with the initial pituitary lesion, the final diagnosis was modified to LCH. The patient was treated with multiple chemotherapy courses. However, the patient’s condition gradually worsened, and she eventually passed away at home.
CONCLUSION
LCH should be considered when patients exhibit diabetes insipidus and absence of high signal intensity in the pituitary gland on sagittal T1-weighted image and abnormal enhancement in the pituitary region.
Core Tip: This case report details Langerhans cell histiocytosis (LCH) presenting in the pituitary gland of a 25-year-old female patient. The patient’s primary symptom was diabetes insipidus. The case was initially misdiagnosed as chronic inflammation despite postoperative pathological examination. Throughout the course of the disease multiple radiological examinations were conducted, and it was strongly indicated that LCH was the correct diagnosis. This case highlights the vital importance of imaging studies in the diagnosis of this condition.
