Langerhans Cell Histiocytosis In Lumbar Spine - A Rare Case Report

Background: Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia caused by mutations in the MAP kinase (MAPK) pathway. It is a rare disorder that can damage tissue or cause lesions in various parts of the body. The disease arises from LCH cells—a type of dendritic white blood cell involved in immune defense.Objective: To present a rare case of LCH in the lumbar spine for academic discussion.Methods: This case report was conducted in the Department of Orthopedics and Spine Surgery at Ibn Sina Hospital, Dhanmondi, Dhaka, from October, 2021 to October, 2024. An 11-year-old boy presented with low back pain, bilateral sciatica, weakness of both lower limbs, and inability to walk. Imaging studies, including X-ray, CT scan, and MRI, revealed a solitary osteolytic lesion in the L2 vertebral body, with moderate contrast enhancement on MRI. L2 corpectomy and interbody fusion were performed using a titanium mesh cage with bone grafting. Posterior stabilization was achieved with titanium pedicle screws and rods. Postoperatively, the patient’s back pain resolved, and neurological function improved within 2–3 days, allowing ambulation with support. Histopathological analysis confirmed the diagnosis of LCH. No postoperative radiotherapy was administered.Result: At 10-month follow-up, no local recurrence was observed. Implants and screws were removed. Mesh cage was left in situ. At 3-year follow-up, there was still no recurrence.Conclusion: In case of lumbar spine LCH, surgery should be considered for neurological deficits or uncertain histological diagnoses. En bloc vertebral resection can alleviate symptoms and prevent local recurrence. The Journal of Ad-din Women's Medical College;Vol. 14(2), July 2026; p 33-37