Adult Langerhans cell histiocytosis with pulmonary and colorectoanal involvement: a case report

J Med Case Rep. 2017 Sep 25;11(1):272. doi: 10.1186/s13256-017-1428-7.

Abstract

Background: Langerhans cell histiocytosis is a rare systemic disease characterized by the abnormal overproduction of histiocytes that tend to infiltrate single or multiple organ systems leading to significant tissue damage. It mainly affects - by order of decreasing frequency - the bone, the skin, the lymph nodes, the liver, and lungs. Gastrointestinal tract involvement is extremely rare in adults.

Case presentation: We describe the case of a 32-year-old Middle Eastern man with Langerhans cell histiocytosis involving his lungs and the colorectoanal part of his gastrointestinal tract, with complete resolution of gastrointestinal tract lesions following a non-standardized chemotherapy regimen.

Conclusions: Gastrointestinal tract lesions are a rare manifestation of Langerhans cell histiocytosis, especially when associated with extraintestinal involvement, such as the lungs. Chemotherapy protocols have not been well established for the treatment of the disease. The clinical impact of the effective chemotherapy regimen used to treat this uncommon presentation of Langerhans cell histiocytosis will be viewed in this case report.

Keywords: Chemotherapy; Histiocytosis X; Immunohistochemistry; Langerhans cell histiocytosis; Multisystem involvement.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Anus Diseases / diagnosis
  • Anus Diseases / drug therapy
  • Anus Diseases / pathology
  • Colonic Diseases / diagnosis
  • Colonic Diseases / drug therapy
  • Colonic Diseases / pathology*
  • Colonoscopy
  • Cytarabine / administration & dosage
  • Disease Progression
  • Histiocytosis, Langerhans-Cell / diagnosis
  • Histiocytosis, Langerhans-Cell / drug therapy
  • Histiocytosis, Langerhans-Cell / pathology*
  • Humans
  • Lung Diseases / diagnosis
  • Lung Diseases / drug therapy
  • Lung Diseases / pathology*
  • Male
  • Prednisone / administration & dosage
  • Rectal Diseases / diagnosis
  • Rectal Diseases / drug therapy
  • Rectal Diseases / pathology*
  • Tomography, X-Ray Computed
  • Vinblastine / administration & dosage

Substances

  • Cytarabine
  • Vinblastine
  • Prednisone