Unusual findings in two cases of Langerhans' cell histiocytosis

We report unusual findings in two patients with Langerhans' cell histiocyto sis (LCH), namely a cervical mass lesion with extensive destruction of the posterior elements of a cervical vertebra and gastrointestinal lesions as p art of multisystem involvement. The aim of our report is threefold. Firstly , LCH can be responsible for osteolysis of the vertebral posterior arches, with or without involvement of the vertebral body, and should be included i n the differential diagnoses of cervical mass lesions. Secondly, in a patie nt with confirmed LCH and additional protein-losing enteropathy, gastrointe stinal involvement should be considered as a possibility since it is an imp ortant factor for establishing prognosis. Thirdly, LCH lesions can be very extensive and yet have a good response to therapy, whereas less spectacular lesions may not respond or respond only partially to therapy. Thus, an imp ortant factor in establishing prognosis is the presence of multisystem invo lvement at diagnosis, regardless of the extent of a lesion at a particular site.