Division of Oral and Maxillofacial Pathology, Columbia University College of Dental Medicine, New York, New York.
Periodontist, Private practice, Manhattan, New York.
J Endod. 2017 Nov;43(11):1909-1914. doi: 10.1016/j.joen.2017.05.020. Epub 2017 Aug 30.
Langerhans cell histiocytosis (LCH) is a clonal neoplastic proliferation of Langerhans-type dendritic cells, with more than 50% of cases of LCH seen in children younger than 15 years of age. The most common clinical presentation of LCH is solitary or multiple bony lesions. The jaws are affected in approximately 10%-20% of cases, with a strong predilection for the mandible. The maxilla is involved in only 1% of head and neck cases. When the jaws are involved, lesions of LCH may mimic periapical pathology as seen in patients requiring endodontic therapy or bone loss as seen in periodontal disease. We report the case of a 39-year-old man with LCH involving the posterior maxilla. This is a rare presentation of LCH with respect to both location and patient age. Clinicians should consider LCH when developing a differential diagnosis of an apical radiolucency of vital teeth or teeth that fail to respond to endodontic therapy and be aware of its clinical and radiographic mimics.
朗格汉斯细胞组织细胞增生症（LCH）是朗格汉斯型树突状细胞的克隆性肿瘤性增生，超过 50%的 LCH 发生在 15 岁以下的儿童。LCH 最常见的临床表现是单发或多发骨病变。颌骨受累约占 10%-20%，以下颌骨多见。上颌骨仅占头颈部病例的 1%。当颌骨受累时，LCH 的病变可能类似于根尖周病变，见于需要根管治疗的患者，或类似于牙周病的骨丢失。我们报告了一例 39 岁男性的上颌后区 LCH 病例。就位置和患者年龄而言，这是 LCH 的一种罕见表现。临床医生在对活髓牙或根管治疗后无反应的牙的根尖透光区进行鉴别诊断时应考虑 LCH，并了解其临床和影像学表现。
