Langerhans cell histiocytosis in an adult with oral cavity involvement: Posing a diagnostic challenge

Nangalia, Richa; Chatterjee, Rudra Prasad; Kundu, S. S.; Pal, Mousumi

doi:10.4103/ccd.ccd_432_18

Cited by 10 publications

(15 citation statements)

References 10 publications

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“…Oral cavity involvement, with or without mandibular infiltration, occurs early in LCH, but it is frequently misdiagnosed as the initial symptoms may be non-specific [31]. Involvement of the alveolar bone leads to a "tooth floating in air" appearance, causing tooth mobility and displacement, thereby mimicking periodontitis [31]. Mucosal lesions are usually localized in the buccal mucosa and at the back of the vestibule.…”

Section: Disease Manifestationsmentioning

confidence: 99%

Adult Langerhans Cell Histiocytosis and the Skeleton

Georgakopoulou

Anastasilakis

Makras

2022

JCM

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Langerhans cell histiocytosis (LCH) is a rare inflammatory neoplasia in which somatic mutations in components of the MAPK/ERK pathway have been identified. Osseous involvement is evident in approximately 80% of all patients and may present as a single osteolytic lesion, as a multi-ostotic single system disease or as part of multisystem disease. Both exogenous, such as treatment with glucocorticoids, and endogenous parameters, such as anterior pituitary hormone deficiencies and inflammatory cytokines, may severely affect bone metabolism in LCH. Computed tomography (CT) or magnetic resonance imaging (MRI) are usually required to precisely assess the degree of bone involvement; 18F-fluorodeoxyglucose (FDG) positron emission tomography—CT can both detect otherwise undetectable LCH lesions and differentiate metabolically active from inactive or resolved disease, while concomitantly being useful in the assessment of treatment response. Treatment of skeletal involvement may vary depending on location, extent, size, and symptoms of the disease from close observation and follow-up in unifocal single-system disease to chemotherapy and gene-targeted treatment in cases with multisystem involvement. In any case of osseous involvement, bisphosphonates might be considered as a treatment option especially if pain relief is urgently needed. Finally, a patient-specific approach is suggested to avoid unnecessary extensive surgical interventions and/or medical overtreatment.

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Section: Disease Manifestationsmentioning

confidence: 99%

Adult Langerhans Cell Histiocytosis and the Skeleton

Georgakopoulou

Anastasilakis

Makras

2022

JCM

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“…There is as sex predilection in men with the peak incidence in the first to second decades of life, generally, LCH is considered a pediatric disease [27]. The mandible is more affected than maxilla especially in the premolar and molar regions [26]. It appears clinically as uni-focal or multi-focal painful swelling, tooth mobility, gingival enlargement, and mucosal ulcerations [26].…”

Section: • Langerhans Cell Histiocytosis (Lch)mentioning

confidence: 99%

Vulnerability and Weaknesses of Eating Habits of Overweight School Children as an Entry Risk for COVID-19

Metwally

Shaaban

Mahmoud

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: In developing countries, overweight among children becomes an alarming problem and a health concern. Obesity is a factor in disease severity of coronavirus disease (COVID-19) having the greatest impact on patients. AIM: The aim of this study was to determine the prevalence of overweight in some of the Egyptian governmental primary school children, its nutritional and socioeconomic determinants. Special focus was directed to identify the current dietary practices including risky nutritional habits of overweight children as a weak point leading to increasing their vulnerability to catching COVID-19 infection. METHODS: A cross-sectional observational study was conducted on primary school children aged 6–12 years. General demographic data, socioeconomic data, dietary pattern, intake of a diversity of nutrient-rich food versus calorie-dense food, and anthropometrical data were collected. RESULTS: Of 1600 child, there were 8% overweight who are considered at risk of COVID-19 infection. Considering the weekly share of the stomach, only one-third of the food consumed by overweight children is nutrient-rich, with high consumption of French fries and Candies (once per day among 95% and 78 % of overweight children, respectively). Moreover, 90% of them consume sugar-sweetened beverages (SSB) more than once per day. The majority of overweight children belonged to small, middle- income families, and had illiterate or read and write mothers. CONCLUSION: Overweight children eat narrow diversity of nutrient-rich food that includes vegetables, fruits, protein, and dairy products. They eat more calorie-dense foods, every day. The increase of family income increased the likelihood of having overweight children with a high intake of SSB, candies, and chips; consumption of snacks between meals and before sleep. Protective predictors against overweight were highly educated mothers, taking breakfast before school, having dinner, and taking meals on time. RECOMMENDATION: Nutritional behavioral education aiming at choosing nutritious and varied options of food that is effective for improving children’s nutritional status is the key to decreasing vulnerability toward COVID 19.

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“…LCH is a rare hematologic disorder divided into three types [26]. There is as sex predilection in men with the peak incidence in the first to second decades of life, generally, LCH is considered a pediatric disease [27].…”

Section: • Langerhans Cell Histiocytosis (Lch)mentioning

confidence: 99%

“…The mandible is more affected than maxilla especially in the premolar and molar regions [26]. It appears clinically as uni-focal or multi-focal painful swelling, tooth mobility, gingival enlargement, and mucosal ulcerations [26]. Radiographically, it characterized by sharply punched out or ill-defined radiolucencies without corticated borders.…”

Section: • Langerhans Cell Histiocytosis (Lch)mentioning

confidence: 99%

“…Radiographically, it characterized by sharply punched out or ill-defined radiolucencies without corticated borders. Alveolar bone involvement mat leads to a tooth floating appearance, causing tooth mobility and thereby mimicking the periodontitis feature [26], [27]. Corticosteroid therapy, surgery, and chemotherapy have been suggested as the treatment of choice [26].…”

Section: • Langerhans Cell Histiocytosis (Lch)mentioning

confidence: 99%

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Oral Hard Tissue Lesions: A Radiographic Diagnostic Decision Tree

Mortazavi

Safi

Rahmani

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Focusing on history taking and an analytical approach to patient’s radiographs, help to narrow the differential diagnoses. AIM: This narrative review article aimed to introduce an updated radiographical diagnostic decision tree for oral hard tissue lesions according to their radiographic features. METHODS: General search engines and specialized databases including PubMed, PubMed Central, Scopus, Embase, EBSCO, ScienceDirect, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “jaw diseases,” “maxilla,” “mandible,” “radiolucent,” “radiopaque,” “odontogenic,” “nonodontogenic,” “cysts,” and “tumors.” Related English-language articles published from 1973 to 2020, including reviews, meta-analyses, and original papers (randomized or non-randomized clinical trials; prospective; or retrospective cohort studies), case reports, and case series about oral hard tissue lesions were appraised. RESULTS: In this regard, bony lesions have been classified according to their radiographic pattern (radiolucent, mixed, radiopaque, and rarified), position (periapical, pericoronal and interradicular), margins (well and ill-defined), relation to dentition (with and without dental association), and number (solitary and multiple). In total, 50 entities were organized in the form of a decision tree. CONCLUSION: In this paper, an updated decision tree was proposed to help dental practitioners to make more accurate diagnoses and better treatment plans on the basis of radiographic characteristics.

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Langerhans cell histiocytosis in an adult with oral cavity involvement: Posing a diagnostic challenge

Cited by 10 publications

References 10 publications

Adult Langerhans Cell Histiocytosis and the Skeleton

Adult Langerhans Cell Histiocytosis and the Skeleton

Vulnerability and Weaknesses of Eating Habits of Overweight School Children as an Entry Risk for COVID-19

Oral Hard Tissue Lesions: A Radiographic Diagnostic Decision Tree

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