LANGERHANS CELL HISTIOCYTOSIS MISDIAGNOSED AS MULTIFOCALL OSTEOMYELITIS IN AN OLD PATIENTS. : A CASE REPORT

중년 남환에서 다병소성(多病巢性) 골수염으로 오진된 Langerhans Cell Histiocytosis (LCH)의 치험례

  • Kim, Sang-Soo (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Park, Hyung-Sik (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Yong, Hyun-Jung (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Huh, Jin-Young (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Kim, Jin-Kwon (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Jung, Jae-Ho (Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • 김상수 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 박형식 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 윤현중 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 허진영 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 김진권 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 정재호 (연세대학교 치과대학 구강악안면외과학교실)
  • Published : 1997.03.31

Abstract

Langerhans Cell Histiocytosis(Idiopathic Histiocytosis, Histiocytosis-X) is most often found in children and young adults, and cell proliferation with specific phenotype shows ultrastructural and immunohistochemical similarities with Langerhans Cells that normally exist in epithelium and mucosa. This disease occurs as single or multiple lesions in skull, ribs, vertebrae, mandible and long bones, and when it involves mandible, clinical sign and symptoms such as bone swelling and pain are noticed. When it involves alveolar bone, severe tooth mobility as well as gigival inflammation, proliferation, and ulceration are commonly found, and so it is not easy to differentiate it from general inflammatory diseases. Any local lesion at the tooth apex on the x-ray view needs to be differentiated from inflammatory disease, and multiple lesions from multiple ostoeoma and chronic multifocal osteomyelitis. This case is LCH in 51-year-old male patient ; this is a rare case, for the patient belongs to an age group with very low incidence rate of the disease. although three-timed biopsy tests and longterm observation at two university hospitals, it was misdiagnosed as multifocal osteomyelitis.

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