DR. SONAM AHUJA

DR. MD. SHAHID ALAM

Abstract

An 8-year-old boy presented with a complaint of right painful upper lid swelling for 25 days following trauma a month back. CT scan reported a subperiosteal abscess with the bony defect. On examination, there was inferior dystopia with tender mass palpable in the supero-temporal quadrant. MRI showed a lytic lesion in the superolateral quadrant with heterogenous enhancing mass. On Incision biopsy, thick yellow color fluid was aspirated from the lesion. Histopathology revealed large histiocytic cells with eosinophils, neutrophils, and multinuclear giant cells. Immunohistochemistry positive for CD1a, CD68, CD 45, CD 20, CD 3, S100 suggested Langerhans cell histiocytosis. The patient was referred to a pediatric oncologist for management. Langerhans cell histiocytosis is a rare disorder characterized by proliferation of pathologic Langerhans cells of monocyte-macrophage lineage or dendritic system. Treatment modalities are observation, biopsy and curettage, and steroid with chemotherapy.