Pulmonary langerhans cell histiocytosis masquerading as tuberculosis in an infant

Abstract

A 4-month-old infant presented with continued fever, unresolving bronchopneumonia and household contact with sputum-smear-positive tuberculosis (TB) and showed marginal improvement on anti-TB chemotherapy. Recurrent pneumothorax prompted the clinical diagnosis of TB to be revised. High-resolution CT scan of the chest and open lung biopsy confirmed the diagnosis of pulmonary Langerhans cell histiocytosis. Treatment with prednisolone and vinblastin resulted in settling of fever and resolution of respiratory symptoms and signs. In communities where the prevalence of TB is high, unusual presentations should prompt consideration of alternative diagnoses.

Pulmonary Langerhans Cell Histiocytosis(PLCH) masquerading as Atypical Mycobacterial infection

“… Pulmonary Langerhans Cell Histiocytosis is an uncommon interstitial Lung disease now considered as been grown from one clone of cells with BRAF mutation (BRAF V600 E) along with markers, S100, CD1a and CD 207/Langerin; now considered a form of malignancy (myeloid neoplasm) with inflammatory properties [ 8 ]. Smoking is a major associated risk factor, resulting in improvement in many and no improvement in some cases after quitting smoking.…”

Langerhans cell histiocytosis or tuberculosis on a medieval child (Oppidum de la Granède, Millau, France – 10th–11th centuries AD)

“…It is sometimes difficult, when considering only skeletal changes, to differentiate between these diseases. This is noticeably the case for Langerhans cell histiocytosis (LCH) and tuberculosis (TB), which can be clinically mistaken [1,2]. Interestingly, before its clinical recognition, LCH was confused with TB 3 .…”