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From normal to abnormal MR findings within three weeks in a solitary pelvic Langerhans histiocytosis
Po-Cheng Hung1, Huei-Shyong Wang, Tang-Her Jaing
1Division of Pediatric Neurology, Chang Gung Children's Hospital, College of Medicine Chang Gung University, Taoyuan, Taiwan. hongfh@ms14.hinet.net
Abstract:
We present a histologically proven case of pelvic Langerhans histiocytosis (eosinophilic granuloma) which showed abnormality on MR imaging 3 weeks after a normal MR examination mimicking an infection.
Insights
Pelvic Langerhans histiocytosis, also known as eosinophilic granuloma, can present as a new abnormality on MRI scans. This rare condition may mimic infection on imaging, highlighting the need for careful diagnosis.
Area of Science:
- Oncology
- Radiology
- Pediatric Pathology
Background:
- Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder of Langerhans cells.
- Pelvic involvement in LCH, particularly in adults, is uncommon.
- Eosinophilic granuloma is a term often used for the localized, unifocal form of LCH.
Observation:
- A case of histologically confirmed pelvic Langerhans histiocytosis is presented.
- Initial magnetic resonance (MR) imaging was normal.
- A follow-up MR examination three weeks later revealed new abnormalities.
Findings:
- The MR imaging findings in the follow-up examination mimicked an infectious process.
- The progression of findings on serial MR imaging is a key diagnostic clue.
- Histological confirmation established the diagnosis of Langerhans histiocytosis.
Implications:
- This case underscores the importance of considering Langerhans histiocytosis in the differential diagnosis of pelvic lesions, even with initially normal imaging.
- Serial imaging can be crucial for detecting subtle changes and guiding diagnosis in rare conditions.
- Radiologists and clinicians should be aware of the potential for Langerhans histiocytosis to mimic infection on pelvic MRI.
