Histiocytose langerhansienne : place actuelle de l’imagerie

Abstract

Langerhans cell histiocytosis (LCH) is a rare disease of the reticuloendothelial system which consists in various clinical manifestations from a single lytic bone lesion to multisystemic lesions with organ dysfunction. One single bone lesion, the most frequent presentation, has a good prognosis. We relate here the case of a 4-year-old child who had a pain of his right hip with lameness and fever. The bone scintigraphy (BS) highlighted an increased uptake of the right iliac wing. Biopsy of the lesion led to the diagnosis of LCH. The progression was spontaneously favourable with relief of pain after the biopsy. This case report allows us to highlight the most recent guidelines regarding the classification of the disease and the indication of imaging. Staging is currently based on chest radiograph, abdominal ultrasound and skeletal radiograph survey. The role of BS, MRI and FDG PET/CT for staging remains to be clarified.