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Langerhans cell histiocytosis masquerading as tuberculosis: A diagnostic dilemma resulting in inappropriate anti‐tubercular therapy
Author(s) -
Sharma Prashant,
Dhingra Kajal Kiran,
Sural Sumit,
Mandal Ashish Kumar,
Singh Tejinder
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21930
Subject(s) - medicine , langerhans cell histiocytosis , tuberculosis , dilemma , histiocytosis , dermatology , intensive care medicine , pathology , disease , philosophy , epistemology
Langerhans cell histiocytosis is known to mimic many other conditions. We present two patients where anti‐tubercular therapy was instituted when clinical and radiological features suggested tuberculosis. The correct diagnosis of histiocytosis was reached only on further work‐up including immunohistochemistry following un‐responsiveness to treatment. In retrospect it was felt that an inordinately high index of suspicion for tuberculosis, clinical and radiological overlap between the two entities, an urgency to start empirical therapy in a rapidly deteriorating patient and pathological similarities between epithelioid histiocytes and pathologic Langerhans cells led to the diagnostic and therapeutic errors. Pediatr Blood Cancer 2009;53:111–113. © 2009 Wiley‐Liss, Inc.