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[Isolated histiocytosis X as rare differential diagnosis of indistinguishable neck lymph node swelling. A case
1Klinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Lübeck.
Insights
This case report highlights histiocytosis X, a rare cause of persistent neck swelling. Diagnosis required lymph node biopsy after initial fine needle aspiration biopsy (FNP) proved inconclusive.
Area of Science:
- Otorhinolaryngology
- Oncology
- Pathology
Background:
- Cervical lymphadenopathies present a diagnostic challenge with numerous differential diagnoses.
- Sonographically controlled fine needle aspiration biopsy (FNP) is a key diagnostic tool for persistent neck swellings.
Observation:
- A 63-year-old male presented with a 6-week history of right-sided neck swelling.
- Initial FNP and blood tests showed no pathological findings.
Findings:
- Histological examination of an excised lymph node confirmed a rare case of isolated histiocytosis X.
- Staging examinations ruled out systemic manifestation of the disease.
Implications:
- This case underscores the importance of lymph node biopsy when initial investigations for cervical lymphadenopathy are non-diagnostic.
- Complete surgical excision of the affected lymph node was curative for this rare presentation of histiocytosis X.
Abstract:
Cervical lymphadenopathies are widespread diseases in otorhinolaryngology. There are many differential diagnoses which have to be considered when swelling persists. To gain further information it is advisable to perform sonographically controlled fine needle aspiration biopsy (FNP). If there is no reliable result, it is necessary to remove a lymph node. We report on the rare case of isolated histiocytosis X in lymph nodes. A 63-year-old male had noticed a swelling of the right side of the neck about 6 weeks previously. The preliminary examinations (FNP/blood examinations) revealed no pathological findings. Only the histological examination delivered the diagnosis of histiocytosis X. Systemic manifestation was excluded by staging examinations. No further therapy was necessary after lymph node extirpation. The report demonstrates how to diagnose and treat this rare disease.