Purpose or Case Report: Langerhans Cell Histiocytosis (LCH) is a rare clonal disorder of the mononuclear phagocyte system, characterized by the proliferation of pathologic Langerhans cells that may involve one or multiple organ systems. Its clinical and imaging manifestations are remarkably diverse, ranging from isolated skeletal lesions to disseminated multisystemic disease. Given this heterogeneity and frequent overlap with other entities, imaging plays a pivotal role in establishing the diagnosis, evaluating disease extent, and guiding follow-up.
To complement this educational overview, we performed a retrospective assessment of all pediatric LCH cases diagnosed in our institution over the past 10 years (2015-2025). A total of 81 patients were identified, with a mean age at diagnosis of 6.5 years (range 0–17.5) and an equal sex distribution. Patient were imaged using plain films as well as advanced imaging modalities including brain and whole body MR imaging and PET-CT or bone scintigraphy. Bone involvement was by far the most frequent manifestation, observed in approximately 83% of cases. Multisystemic disease occurred in about one-third of patients, typically at a younger age, while central nervous system lesions—often associated with cranial bone involvement—were identified in nearly 10% of cases. Involvement of the skin, liver, and marrow predominated among early-onset forms. These findings align with previously described epidemiologic and imaging patterns of pediatric LCH.
By integrating imaging patterns and clinical presentation, this work aims to serve as a practical reference for pediatric radiologists. Through a systematic approach, it enhances familiarity with the imaging spectrum of LCH and supports improved diagnostic confidence and patient management.
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