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伴有口腔表现的朗格汉斯细胞组织细胞增多症:一例罕见且特殊的病例报告

Langerhans cell histiocytosis with oral manifestations: a rare and unusual case report.

作者信息

Yashoda-Devi Bk, Rakesh N, Agarwal Manjushree

机构信息

MDS, Professor and HOD, Department of Oral Medicine and Radiology, M S Ramaiah Dental College and Hospital, Bangaluru.

MDS, Associate Professor, Department of Oral Medicine and Radiology, M S Ramaiah Dental College and Hospital, Bangaluru.

出版信息

J Clin Exp Dent. 2012 Oct 1;4(4):e252-5. doi: 10.4317/jced.50728. eCollection 2012 Oct.

Abstract

Langerhans cell histiocytosis (LCH), is a rare, proliferative disorder in which the accumulation of pathologic Langerhans cells leads to local tissue infiltration and destruction. We present a case of a 32 years old, completely edentulous female patient who presented with erythema of hard palate, maxillary alveolar mucosa and mucosa over the distobuccal part of mandibular alveolar ridge with foci of ulcerations. Histopathologic features were suggestive of LCH which was confirmed by immunohistochemistry which was CD1a positive, confirmatory for LCH. Bone scan revealed multiple bone involvement. At this stage, disease had already progressed to multisystem involvement with endocrinal abnormalities (primary hypothyroidism and hyperprolactinemia), requiring aggressive treatment. Therefore, this case is a reminder of the possibility of occurrence of this rare disease in the oral cavity which might manifest itself in multiple presentations thus easily leading to the misdiagnosis and therefore, it could be easily overlooked by dentists. Key words:Langerhans cell histiocytosis, immunohistochemistry, bone scan.

摘要

朗格汉斯细胞组织细胞增多症(LCH)是一种罕见的增殖性疾病,其中病理性朗格汉斯细胞的积累导致局部组织浸润和破坏。我们报告一例32岁的完全无牙女性患者,其硬腭、上颌牙槽黏膜以及下颌牙槽嵴远颊侧部分的黏膜出现红斑,并伴有溃疡灶。组织病理学特征提示为LCH,免疫组织化学检查CD1a阳性证实了这一诊断,对LCH具有确诊意义。骨扫描显示多处骨骼受累。在此阶段,疾病已进展为多系统受累并伴有内分泌异常(原发性甲状腺功能减退和高催乳素血症),需要积极治疗。因此,该病例提醒人们,这种罕见疾病有可能出现在口腔中,可能有多种表现形式,从而容易导致误诊,因此牙医可能很容易忽视它。关键词:朗格汉斯细胞组织细胞增多症;免疫组织化学;骨扫描

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