Langerhans' cell histiocytosis in patients older than 21 years

In this retrospective review of 541 patients with Langerhans' cell histiocy tosis, 211 (39%) patients were older than 21 years of age, whereas 330 (61% ) were younger than 21 years of age. The adult patients had a mean age of 3 2 years (range, 21-69 years) with 159 (75%) men and 52 (25%) women, whereas the pediatric patients consisted of 176 (55%) boys and 144 (45%) girls, Th is male predominance in adults was statistically significant, Three adults had the Hand-Schuller-Christian variant, whereas the remaining adults (208) had eosinophilic granuloma, The rib accounted for 25% of the adult lesions and only 8% of the pediatric lesions. Spine involvement was less common in the adult group (3% versus 10%) and was predominantly thoracic. The adult patients had 40 (77%) diaphyseal lesions, 12 (23%) metaphyseal lesions, and no epiphyseal lesions, The pediatric patients had 75 (54%) diaphyseal, 59 (42%) metaphyseal, and five (4%) epiphyseal lesions. Radiographic evaluatio n revealed similar margin and matrix patterns in both groups, with a geogra phic lesion without sclerotic borders being the most common pattern. Langer hans' cell histiocytosis is considered a pediatric disease, However, this s tudy showed a significant number (39%) of patients older than 21 years of a ge with this condition.