Contrast-enhanced sonography in the diagnosis of Langerhans cell hyperplasia in children with isolated liver involvement

{"RATIONALE:":[0],"Isolated":[1],"hepatic":[2,33,129,178],"involvement":[3],"of":[4,31,51,82,111,177,194,210],"Langerhans":[5],"cell":[6],"histiocytosis":[7],"(LCH)":[8],"in":[9,198],"the":[10,74,80,83,93,173,191],"pediatric":[11],"population":[12],"is":[13,21,203,216],"an":[14],"exceedingly":[15],"rare":[16],"condition.":[17],"Its":[18],"clinical":[19,204],"presentation":[20],"nonspecific,":[22],"and":[23,59,77,88,123,140,152,225],"its":[24],"imaging":[25,62,69,102],"features":[26,215],"frequently":[27],"overlap":[28],"with":[29,47,138,149],"those":[30],"other":[32],"focal":[34,195],"lesions,":[35,180],"rendering":[36],"preoperative":[37],"diagnosis":[38,110,193],"particularly":[39,200],"challenging.":[40],"PATIENT":[41],"CONCERNS:":[42],"An":[43],"11-year-old":[44],"girl":[45],"presented":[46],"a":[48,86,105,160,183],"chief":[49],"complaint":[50],"intermittent":[52],"abdominal":[53],"pain.":[54],"DIAGNOSES:":[55],"Enhanced":[56],"computed":[57],"tomography":[58],"magnetic":[60],"resonance":[61],"revealed":[63],"multiple":[64],"liver":[65,117,196],"nodules.":[66],"A":[67],"characteristic":[68],"pattern":[70],"was":[71,113,147],"observed:":[72],"during":[73],"portal":[75],"venous":[76],"delayed":[78],"phases,":[79],"periphery":[81],"lesions":[84,197],"exhibited":[85],"\\"wash-in":[87],"wash-out\\"":[89],"enhancement":[90],"pattern,":[91],"while":[92],"central":[94],"areas":[95],"remained":[96],"non-enhancing":[97],"throughout":[98],"all":[99],"phases.":[100],"This":[101,164,218],"finding":[103],"provided":[104],"crucial":[106],"diagnostic":[107,223],"clue.":[108],"The":[109,132,145],"LCH":[112,179],"ultimately":[114],"confirmed":[115],"by":[116,120],"biopsy,":[118],"supplemented":[119],"electron":[121],"microscopy":[122],"immunohistochemistry.":[124],"Systemic":[125],"evaluation":[126],"verified":[127],"isolated":[128],"involvement.":[130],"INTERVENTIONS:":[131],"patient":[133,146],"received":[134],"immunosuppressant":[135,150],"therapy":[136,151],"combined":[137],"prednisone":[139],"vindesine-based":[141],"combination":[142,153],"chemotherapy.":[143,154],"OUTCOMES:":[144],"treated":[148],"Follow-up":[155],"at":[156],"6":[157],"months":[158],"indicated":[159],"favorable":[161],"recovery.":[162],"LESSONS:":[163],"case":[165],"illustrates":[166],"that":[167],"contrast-enhanced":[168,213],"ultrasound":[169,214],"can":[170,220],"effectively":[171],"delineate":[172],"unique":[174],"hemodynamic":[175],"characteristics":[176],"serving":[181],"as":[182],"valuable":[184],"supplement":[185],"to":[186],"conventional":[187],"cross-sectional":[188],"imaging.":[189],"In":[190],"differential":[192],"children,":[199],"when":[201],"there":[202],"suspicion":[205],"for":[206],"LCH,":[207],"increased":[208],"recognition":[209],"these":[211],"specific":[212],"crucial.":[217],"awareness":[219],"help":[221],"prevent":[222],"delays":[224],"guide":[226],"targeted":[227],"pathological":[228],"sampling.":[229]}

Authors

Institutions

Publication Details

Journal
Medicine
Published
2026-09-18
DOI
https://doi.org/10.1097/md.0000000000050779
Primary Topic
Histiocytic Disorders and Treatments
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
article

Contrast-enhanced sonography in the diagnosis of Langerhans cell hyperplasia in children with isolated liver involvement

彭敏娟, Yuanbo Wu, Xinyu Yan, Ni Ni et al.
Medicine
Histiocytic Disorders and Treatments
article

Contrast-enhanced sonography in the diagnosis of Langerhans cell hyperplasia in children with isolated liver involvement

彭敏娟, Yuanbo Wu, Xinyu Yan, Ni Ni, Liu Yang
article en

Abstract

RATIONALE: Isolated hepatic involvement of Langerhans cell histiocytosis (LCH) in the pediatric population is an exceedingly rare condition. Its clinical presentation is nonspecific, and its imaging features frequently overlap with those of other hepatic focal lesions, rendering preoperative diagnosis particularly challenging. PATIENT CONCERNS: An 11-year-old girl presented with a chief complaint of intermittent abdominal pain. DIAGNOSES: Enhanced computed tomography and magnetic resonance imaging revealed multiple liver nodules. A characteristic imaging pattern was observed: during the portal venous and delayed phases, the periphery of the lesions exhibited a "wash-in and wash-out" enhancement pattern, while the central areas remained non-enhancing throughout all phases. This imaging finding provided a crucial diagnostic clue. The diagnosis of LCH was ultimately confirmed by liver biopsy, supplemented by electron microscopy and immunohistochemistry. Systemic evaluation verified isolated hepatic involvement. INTERVENTIONS: The patient received immunosuppressant therapy combined with prednisone and vindesine-based combination chemotherapy. OUTCOMES: The patient was treated with immunosuppressant therapy and combination chemotherapy. Follow-up at 6 months indicated a favorable recovery. LESSONS: This case illustrates that contrast-enhanced ultrasound can effectively delineate the unique hemodynamic characteristics of hepatic LCH lesions, serving as a valuable supplement to conventional cross-sectional imaging. In the differential diagnosis of focal liver lesions in children, particularly when there is clinical suspicion for LCH, increased recognition of these specific contrast-enhanced ultrasound features is crucial. This awareness can help prevent diagnostic delays and guide targeted pathological sampling.

MedicineVol. 105(38)
People's Hospital of Yangzhong (CN)
Good health and well-being
Openalex Percentile: Top 12%
Histiocytic Disorders and Treatments
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.