Langerhans Cell Histiocytosis Masquerading as a Spinal Tumour in a Young Adult : A Case Report

Abstract

Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder of dendritic cells, predominantly affecting children. Adult spinal involvement is uncommon and may radiologically mimic malignant lesions.

A 33-year-old male presented with a three-week history of progressive mid-thoracic back pain without neurological deficits. MRI revealed an infiltrative lesion involving D3-D4 vertebrae with epidural and paraspinal extension, suggestive of a lympho-proliferative neoplasm. Surgical decompression was performed. Histopathological examination showed sheets of histiocytes with characteristic nuclear grooves in an eosinophil-rich background. Immunohistochemistry (IHC) demonstrated positivity for CD1a and S100, confirming LCH.

Adult spinal LCH can mimic malignant tumors on imaging, posing a diagnostic challenge. Histopathology with IHC remains the cornerstone for definitive diagnosis. Early recognition and appropriate multi-disciplinary management are essential for favorable outcomes.