Case study: Langerhans’ cell histiocytosis (LCH)

SummaryThe clinical spectrum of Langerhans cell histiocytosis (LCH) can be very diverse. Pathology can range from a single bony lesion to systemic disease with multi-organ dysfunction. Up to 61% of patients with LCH have otologic involvement and in 5–25% it might be the initial form of presentation [A.J. Goldsmith, D. Myssiorek, E. Valderrama, M. Patel, Unifocal Langerhans’ cell histiocytosis (eosinophilic granuloma) of the petrous apex, Arch. Otolaryngol. Head Neck Surg. 119 (1993) 113–116; R. Hermans, B. De Foer, M.H. Smet, J. Leysen, Eosinophilic granuloma of the head and neck: CT and MRI features in three cases, Pediatr. Radiol. 24 (1994) 33–36; T.V. McCaffrey, T.J. McDonald, Histiocytosis X of the ear and temporal bone: review of 22 cases, Laryngoscope 89 (1979) 1735–1742]. The otologic findings of LCH are similar to otomastoiditis and therefore LCH should be considered as a possible differential diagnosis in very young patients presenting with signs and symptoms suggestive of chronic otitis media.