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Case Reports
. 2019 May;98(20):e15690.
doi: 10.1097/MD.0000000000015690.

Cervical langerhans cell histiocytosis mimicking cervical tuberculosis: A Case report

Jingcheng Rao  1 , Yuhang Rao  2 , Chong Wang  1 , Yuqiang Cai  1 , Guangru Cao  1
Affiliations
Case Reports

Cervical langerhans cell histiocytosis mimicking cervical tuberculosis: A Case report

Jingcheng Rao et al. Medicine (Baltimore). 2019 May.

Abstract

Rationale: Langerhans cell histiocytosis (LCH) involving adult cervical vertebrae is relatively rare clinically.

Patient concerns: An 18-year-old male patient exhibited a 1-month history of neck pain, restricted neck mobility, and numbness and weakness of both upper limbs. The patient reported no pain at other sites, exhibited no fever or night sweats, and was unable to recall any recent injury.

Diagnoses: On the basis of the radiological features of the lesion and laboratory tests, there was a high possibility that the patient had a tuberculosis lesion. Postoperative GeneXpert and Mycobacterium tuberculosis (MTB) culture results showed MTB negative. Postoperative pathological results showed: (Cervical 4 vertebrae) LCH.

Interventions: Our department did an anterior approach operation. The patient was treated with prednisone combined with vincristine after operation.

Outcomes: The patient was discharged from the hospital with complete remission of cervical pain and rapid relief of neurological symptoms.

Lessons: Computed tomography-guided biopsy of lesion tissue must be performed when a suspected infection occurs in young patients. If possible, the lesion tissue obtained during the operation should be cultured and pathologically examined for early diagnosis.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
(A–C) CT scan view showing osteolytic destruction of the C4 vertebrae. (D) MRI scan view showing osteolytic destruction of the C4 vertebrae, formation of paravertebral and intraspinal abscess. (E–G) Postoperative imaging study showing that the lesion has been completely removed and that the position of the internal fixation device is satisfactory. Postoperative bone bridge formation is visible in the diseased vertebral body. CT = computed tomography, MRI = magnetic resonance imaging.
Figure 2
Figure 2
(A) Low magnification (10 × 10) overview of langerhans cells. (B) High magnification (40 × 10) of langerhans cells, with abundant cytoplasm, pale pink cytoplasm, and lobulated or serrated nucleus. (C) Immunohistochemistry showing S100(+) in tumor cells. (D) Immunohistochemistry showing CD1a(+++) in tumor cells. (E) Immunohistochemistry showing CD68 KP1(+) in tumor cells.
See this image and copyright information in PMC

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