347 - Langerhans Cell Histiocytosis: A Case Report

Abstract:

Introduction:

Langerhans cell histiocytosis (LCH) is a rare clonal disorder characterized by the abnormal proliferation and accumulation of pathologic Langerhans cells, a specialized subset of dendritic cells involved in antigen presentation. The disease exhibits a wide clinical spectrum, ranging from isolated osseous lesions to multisystem involvement with significant morbidity. LCH most commonly affects infants and young children, although it may occur at any age. In the oral and maxillofacial region, clinical manifestations often include painful jaw lesions, gingival inflammation, and premature tooth mobility secondary to alveolar bone destruction. Radiographically, lesions may present as well-defined “punched-out” radiolucencies, giving teeth a characteristic “floating” appearance. Sensory disturbances such as pain or paresthesia may also be present, reflecting local tissue infiltration and bone loss.



Case Report:

This presentation discusses a 7-year old male patient who presented to the dental clinic for emergency visit for lower left jaw swelling that started 6 days prior. Patient reported pressure and discomfort in the area, but no odontogenic pain. This 7-year old’s medical history is noncontributory at the time of first visit with no current medications. The patient has a reported amoxicillin allergy. Clinical examination revealed a hard, fixed intraoral swelling involving the unerupted lower left second molar with associated tenderness and mild pain. Radiographic findings revealed significant radiolucency around #18 area. An incisional biopsy was performed under IV sedation and sent for histological examination. This report will include clinical and histological findings associated with Langerhans cell histiocytosis, differential diagnoses, and treatment rendered to our patient.

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