Perirenal mass of Langerhans cell histiocytosis

Langerhans cell histiocytosis infiltration into pancreas and kidney

An 18-month-old male presented with a swelling of the neck for 2 months. A presumptive diagnosis of Langerhans cell histiocytosis (LCH) was made on fine needle aspiration cytology from the lymph node. The child received chemotherapy. He remained well for around 10 months, when he represented with loose stools, cough, and respiratory distress. His condition deteriorated over a few hours culminating in death. A partial autopsy revealed LCH infiltration in liver, pancreas, and kidneys along with bronchopneumonia. The pancreatic and renal infiltration by LCH is extremely rare.

Clinical aspects of Langerhans cell histiocytosis

Langerhans cell histiocytosis remains an enigmatic disease with protean manifestations. It may be self-limited in some, whereas in others, even intensive treatment is unsuccessful. The outcome depends on whether vital organ function is compromised at diagnosis or shortly thereafter, in which case the prognosis is grave.