Neeta Mohanty
Siksha O’ Anusandhan University, Bhubaneswar, India
Title: Diagnostic pitfalls of adult langerhan’s cell hisyiocytosis with jaw involvement
Biography
Biography: Neeta Mohanty
Abstract
Langerhan’s cell histiocytosis (LCH) a proliferative disorder of histiocytes, encompasses multiple diseases histologically composed of cells having the phenotypic markers of Langerhan’s cells. Owing to it’s incidence of 1-2 in a million, many questions ranging from etio-pathogenesis to therapy remain unanswered. The absence of clinical and radiological pathognomonic features also delays the diagnosis. LCH in adults is rare and with only thirty percent affecting the jaws, we are presenting two cases of adult LCH with jaw involvement and a note on delay in diagnosis. Forty four year old male initially diagnosed as Central giant cell granuloma of mandible and filariasis of maxilla was later diagnosed as LCH when the lesion recurred in the maxilla two years later. Another case of a forty two year old male presented with pain in the spine and was diagnosed and treated for tuberculosis. The development of another lesion in the jaw after five years led us to the diagnosis of LCH. Positive immunoexpression with CD1a, CD207, CD68 and S-100 in both the cases helped in a definitive diagnosis. Osteolytic lesions produced by this group of lesions are also at times misleading since it mimics metastatic tumours and other primary osteolytic lesions. These cases are a reminder of the possibility of occurrence of this rare disease in the oral cavity which might manifest itself in multiple presentations, thus easily leading to misdiagnosis and being overlooked by the diagnostician.