Adult-Onset Multisystem Langerhans Cell Histiocytosis With Bone and Hepatic Involvement: A Rare Case With Radiologic-Pathologic Correlation

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of histiocytic dendritic cells that can mimic metastatic malignancies due to its potential for multiorgan involvement. Histopathologic confirmation is essential for accurate diagnosis. As such, biopsy is imperative, especially in patients who present with hepatic lesions. Adjunctive liver imaging can help confirm the diagnosis, but is rarely performed. Little information is available on imaging features of hepatic involvement in LCH. Here we report a case of a 22-year-old man with a fracture of his cervical spine suspicious for pathological fracture. However, liver imaging and confirmatory histopathology revealed LCH instead of metastatic spread.