Abstract：
Langerhans cell histiocytosis (LCH) is reported less frequently in adults than in children. The most common site of involvement in adults is the bone, accounting for 30-50% of cases. The gastrointestinal tract is very rare, accounting for approximately 2%. We present a case of Langerhans cell histiocytosis that simultaneously invaded multiple organs, including the stomach and colon, in an adult. A 37-year-old woman with no underlying disease complained of chest discomfort and a palpable right submandibular mass. A right Level II neck mass and mediastinal LN enlargement were confirmed on the pharynx and chest CT scan. Multiple subepithelial masses with central ulceration and erosion were observed in the corpus and fundus on the esophagogastroduodenoscopy and in the right colon on the colonoscopy. The histopathology findings were the same in each tissue biopsied from the stomach, colon, and right neck lymph nodes. Langerhans cells with classical reniform nuclei and prominent eosinophils invaded the normal glands, and S100 and CD1a were positive in the immunohistochemical stain. Gastrointestinal involvement of LCH in adults is rare, asymptomatic,and can involve multiple digestive organs simultaneously, so upper endoscopy and colonoscopy should be considered for a diagnosis.
摘要：
据报道，成人朗格汉斯细胞组织细胞增生症（LCH）的发生率低于儿童。成人最常见的受累部位是骨骼，占病例的30-50%。胃肠道非常罕见，约占2%。我们介绍了一个同时侵入多个器官的朗格汉斯细胞组织细胞增生症的病例，包括胃和结肠，在一个成年人。一名没有潜在疾病的37岁女性抱怨胸部不适和可触及的右颌下肿块。咽部和胸部CT扫描证实右侧II级颈部肿块和纵隔LN增大。在食管胃十二指肠镜检查的体部和眼底以及结肠镜检查的右结肠中观察到多个上皮下肿块，并伴有中央溃疡和糜烂。从胃部活检的每个组织的组织病理学发现都是相同的，结肠,和右颈淋巴结.具有经典肾形核和突出嗜酸性粒细胞的朗格汉斯细胞侵入正常腺体，S100和CD1a在免疫组织化学染色中呈阳性。成人LCH的胃肠道受累是罕见的，无症状，可以同时累及多个消化器官，因此，上消化道内镜和结肠镜检查应考虑诊断。
