Multisystemic recurrent Langerhans cell histiocytosis misdiagnosed with chronic inflammation at the first diagnosis: A case report.

IF 1.4 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING World journal of radiology Pub Date : 2024-06-28 DOI:10.4329/wjr.v16.i6.232
Zhan-Rong Zhang, Feng Chen, Hui-Juan Chen
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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.

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初诊时被误诊为慢性炎症的多系统复发性朗格汉斯细胞组织细胞增生症:病例报告。
背景:朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)以糖尿病性尿崩症为特征,并不常见。病理活检仍有一定的诊断可能性。我们介绍了一例 LCH 最初累及垂体的病例。病例摘要:一名 25 岁女性表现出糖尿病症状。磁共振成像显示垂体有强化灶。手术切除垂体病灶后,病理诊断为慢性炎症。然而,患者的颅骨和下肢骨后来出现了骨质破坏。将下肢骨病变与最初的垂体病变进行比较后,最终诊断改为 LCH。患者接受了多个疗程的化疗。然而,患者的病情逐渐恶化,最终在家中去世:结论:当患者出现糖尿病性尿崩症,矢状面T1加权图像上垂体无高信号强度,垂体区域异常强化时,应考虑LCH。
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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
8.00%
发文量
35
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