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Cervical langerhans cell histiocytosis mimicking cervical tuberculosis: A Case report

Jingcheng Rao¹, Yuhang Rao², Chong Wang¹

¹Department of Spine Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou.

|May 18, 2019

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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