克拉屈滨-成人朗格汉斯综合征Langerhans’s cell histiocytosis in old subjects two rare case reports and review of the literature..pdf

C a s e R e p o r t Langerhans’s cell histiocytosis in old subjects: two rare case reports and review of the literature 1 2 1 1 2 Carlo Lajolo , Giuseppina Campisi , Giorgio Deli , Cristiano Littarru , Rosario Guiglia and Michele Giuliani1 1School of Dentistry, Catholic University, Largo A. Gemelli, Rome, Italy; 2Department of Surgery and Oncology Disciplines, Sector of Oral Medicine ‘‘V. Margiotta’’, University of Palermo, Palermo, Italy doi: 10.1111/j.1741-2358.2012.00629.x Langerhans’s cell histiocytosis in old subjects: two rare case reports and review of the literature Background: Langerhans cell histiocytosis (LCH) is a proliferative disease of histiocyte-like cells that generally affects children; LCH onset is rare in adults; immunohistochemistry is essential to obtain the correct diagnosis, and treatment protocols are controversial. Objective: To describe two new cases of adult onset oral LCH. Case reports: Case 1: a 71-year-old woman, complaining of diffuse oral pain, presented with erythem- atous mucosal lesions; the panoramic radiograph and CT scan showed multiple mandible radiolucent areas. Immunohistochemical assay for S-100, CD1a and langerin test was essential in reaching the correct diagnosis. Case 2: a 77-year-old female patient presented with a non-painful, non-bleeding, slightly ele- vated erythematous palatal lesion of 6 months duration, together with a genital vulvar lesion of uncertain nature. The pathology confirmed the diagnosis of LCH. Many therapies (etoposid, radiotherapy) could induce only a clinical partial remission; Cladribine induced a complete recovery. Conclusion: The first case was difficult to diagnose: the clinical presentation and course of the disease (LCH) in the elderly are multiple and unpre