Langerhans Cell Histiocytosis Masquerading as a Spinal Tumour in a Young Adult : A Case Report

Abstract

Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder of dendritic cells, predominantly affectingchildren. Adult spinal involvement is uncommon and may radiologically mimic malignant lesions.A 33-year-old male presented with a three-week history of progressive mid-thoracic back pain without neurologicaldeficits. MRI revealed an infiltrative lesion involving D3–D4 vertebrae with epidural and paraspinal extension, suggestiveof a lymphoproliferative neoplasm. Surgical decompression was performed. Histopathological examination showed sheetsof histiocytes with characteristic nuclear grooves in an eosinophil-rich background. Immunohistochemistry demonstratedpositivity for CD1a and S100, confirming LCH.Adult spinal LCH can mimic malignant tumours on imaging, posing a diagnostic challenge. Histopathology withimmunohistochemistry remains the cornerstone for definitive diagnosis. Early recognition and appropriatemultidisciplinary management are essential for favourable outcomes