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Published on: June 14, 2020
[Langerhans cell histiocytosis presenting as isolated adenitis in an infant: case report]
María Soriano-Ramos1, Enrique Salcedo Lobato2, María Baro Fernández2
1Servicio de Pediatría, Fundación para la Investigación Biomédica Hospital 12 de Octubre, Universidad Complutense, Hospital Universitario 12 de Octubre, Madrid, España. sorianoramosmaria@gmail.com.
Insights
Langerhans cell histiocytosis, a rare infant condition, can present as an isolated neck mass. Early diagnosis via fine needle aspiration is crucial for infants with unresponsive neck swelling.
Area of Science:
- Pediatric Oncology
- Dermatology
- Pathology
Background:
- Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder of Langerhans cells.
- Infantile LCH typically presents with multisystem involvement, making isolated cervical adenitis exceptional.
Observation:
- A 3-month-old infant presented with a right mandibular angle neck mass unresponsive to antibiotics.
- The mass was initially suspected to be infectious or inflammatory due to its presentation.
Findings:
- Fine needle aspiration (FNA) confirmed Langerhans cell histiocytosis.
- Further tests revealed no evidence of systemic LCH involvement, indicating localized disease.
Implications:
- Langerhans cell histiocytosis should be considered in the differential diagnosis of subacute neck masses in infants.
- Prompt FNA is recommended for infants with neck masses exhibiting poor treatment response to establish a definitive diagnosis and guide management.
Abstract:
Langerhans cell histiocytosis in infants is a rare condition, and presentation as an isolated cervical adenitis is exceptional at this age. We describe the case of a 3-month-old female infant presenting with a neck mass in the right mandibular angle with poor response to antibiotic treatment. Fine needle aspiration was performed and confirmed the diagnosis of Langerhans cell histiocytosis with complementary tests showing no features of systemic involvement. Langerhans cell histiocytosis should be considered in the differential diagnosis of subacute neck masses with poor outcome in infants and physicians should consider performing a fine needle aspiration to establish the diagnosis.
