Dhangana Pinky,  Tadros Sameh

Final Pr. ID: Poster #: CR-024

Background: Langerhans cell histiocytosis (LCH) is common in adult smokers but exceedingly rare in children with very few cases reported in the literature of children <12 years who had been reported as having isolated pulmonary LCH.

Case Report: 4-year-old unvaccinated Amish boy, otherwise healthy with no significant past medical history who presented with acute respiratory distress, found to have recurrent bilateral pneumothoraces status post bilateral chest tubes placement. Read More

Authors:  Dhangana Pinky , Tadros Sameh

Keywords:  Langerhans cell histiocytosis

Nyalakonda Ramyashree,  Muehe Anne,  Iles Benjamin,  Theruvath Ashok,  Siedek Florian,  Agarwal Vibhu,  Hawk Kristina,  Jeng Michael,  Daldrup-link Heike

Final Pr. ID: Paper #: 148

To compare the detection of lesions between DW-MRI and ¹⁸F-FDG PET/MR for staging and restaging of Langerhans Cell Histiocytosis (LCH), using all clinical outcomes and imaging data as the reference standard. Also, this study will compare the differences between LCH chemotherapy responders and non-responders. Read More

Authors:  Nyalakonda Ramyashree , Muehe Anne , Iles Benjamin , Theruvath Ashok , Siedek Florian , Agarwal Vibhu , Hawk Kristina , Jeng Michael , Daldrup-link Heike

Keywords:  Langerhans Cell Histiocytosis, Diffusion Weighted Imaging, 18F-FDG PET/MR

Aboagye Rosemond,  Bajno Lydia,  Nadel Helen,  Potts James,  Bray Heather

Final Pr. ID: Poster #: SCI-063

Purpose: ¹⁸F-FDG Positron Emission Tomography (PET-CT) has been shown to be superior to other imaging modalities in assessment of soft tissue involvement with Langerhans Cell Histiocytosis (LCH) and is now commonly included in the staging workup of LCH. Our purpose is to analyze the utility of skeletal survey in addition to PET-CT scan for detecting bone lesions in children with LCH and to evaluate if skeletal survey can be eliminated from the staging workup of LCH in order to reduce radiation exposure. Read More

Authors:  Aboagye Rosemond , Bajno Lydia , Nadel Helen , Potts James , Bray Heather

Keywords:  Langerhans Cell Histiocytosis, PET-CT, Skeletal Survey

Goldstein Elianna,  White Elena,  Giamanco Nicole,  Rooks Veronica

Final Pr. ID: Poster #: CR-021

Langerhans cell histiocytosis (LCH) is a rare neoplastic disorder of abnormal proliferation of Langerhans cells affecting predominantly pediatric populations; sites of involvement include cutaneous, osseous, hematopoietic, and multisystem disease (1). Cutaneous involvement is common in children, though thymic involvement is rarely described (2). We report a case of an 8-month-old female infant with a dyad of cutaneous and thymic LCH. The purpose of this paper is to highlight a potentially underdiagnosed manifestation of infantile LCH and consider thymic sonography in infant LCH staging evaluation.

A one-month old female presented with skin lesions and pruritus suspicious for atopic dermatitis failing to respond to therapy. Punch biopsy demonstrated cutaneous LCH. Staging non-contrast chest computed tomography (CT) showed multiple very faint calcifications in the thymus (figure 1) which could have been obscured by intravenous contrast administration. Ultrasound demonstrated multiple echogenic foci in the thymus (figure 2). Pathology confirmed thymic LCH. Throughout her presentation, the patient’s clinical symptoms of LCH were limited to diffuse pruritic cutaneous lesions. Thymic involvement changed patient management to chemotherapy infusion. At the time of this report she has shown no signs of disease progression and she remains clinically stable. Read More

Authors:  Goldstein Elianna , White Elena , Giamanco Nicole , Rooks Veronica

Keywords:  Langerhans Cell Histiocytosis, Ultrasound, Thymus

Ulikowska Ewelina

Final Pr. ID: Poster #: EDU-012 (T)

Langerhans Cell Histiocytosis (LCH), is a disorder that primarily affects children, but can affect individuals of all ages. Langerhans cells are cells that are responsible for regulating immune system in our bodies. They are mostly found in the skin, spleen, lymph nodes, liver and bone marrow. In patients who have LCH, these cells grow and multiply excessively. The abnormal growth of the Langerhans cells causes a formation of tumors called granulomas. LCH can affect different areas of the body: skin, nails, lymph nodes, gastrointestinal tract, central nervous system, pituitary and thyroid gland, liver, lungs and bones. The severity and symptoms of the disease vary in individual patients and are dependent on the organs and systems affected. Oftentimes, LCH can be found in multiple areas of the body and when that happens, the disease becomes a multisystem disease. The most common system affected by LCH, seen in about 80 % of individuals affected, is the skeletal system. Granulomas, which develop most commonly in the flat bones such as skull and long bones of arms and legs, cause sclerotic and lytic lesions that can in turn become the cause of pathologic fractures. Therefore it is crucial, to recognize the radiographic signs of skeletal manifestations of LCH. Radiography is the preliminary imaging of choice and skeletal surveys are oftentimes the best assessment of the status of LCH prior and post treatment. The purpose of this abstract is to describe radiographic appearances associated with Langerhans Cell Histiocytosis. In order to confirm the importance of follow up skeletal surveys, I will present cases and associated radiographs that show signs of LCH prior to treatment and post treatment. Read More

Authors:  Ulikowska Ewelina

Keywords:  Langerhans Cell Histiocytosis, Radiographic findings, Skeletal manifestations

Barbosa Alberto,  Ladera Gonzalez Enrique,  Navallas Maria,  Inarejos Emili,  Barber De La Torre Ignasi

Final Pr. ID: Poster #: EDU-073

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. Read More

Authors:  Barbosa Alberto , Ladera Gonzalez Enrique , Navallas Maria , Inarejos Emili , Barber De La Torre Ignasi

Keywords:  Histiocytosis, Langerhans Cell Histiocytosis, LCH

Said Yusra,  Walsh John,  Hayes Roisin

Final Pr. ID: Poster #: EDU-078

Langerhans Cell Histiocytosis (LCH) is a rare histiocytic disorder, classically of the paediatric population but which may also affect adults. LCH affects up to 4.1 per million children each year in the UK and Ireland. Our goal in this presentation is to illustrate typical and atypical imaging features of LCH and discuss how these are relevant to further management. Read More

Authors:  Said Yusra , Walsh John , Hayes Roisin

Keywords:  Langerhans cell histiocytosis, Pediatrics

Chalard François,  O'keane Aurélie,  Blondiaux Eleonore,  Ducou Le Pointe Hubert

Final Pr. ID: Poster #: EDU-079

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid tumor, a rare disease that is most often diagnosed in early childhood.
Here, we present the radiological spectrum of manifestations of this disease. The organs most frequently affected are the bone, skin, central nervous system (CNS), lungs, bone marrow, liver, spleen and lymph nodes.
Our review includes illustrations of the regression of severe lung lesions and neurodegenerative lesions, which can be observed under targeted therapy (mitogene-activated protein kinase inhibitor).
In addition, for each lesion, we present a short list of differential diagnoses.
Bone
Langerhans cell histiocytosis is a potentially multisystem disease, but its most common presentation is a single-bone lesion. It predominantly affects the axial skeleton, with the skull being the most frequently affected bone. Bone lesions generally develop slowly and can sometimes be aggressive.
Vertebra plana is a classic aspect of vertebral LCH ; spinal cord compression is rare.
Langerhans cell histiocytosis of the ear primarily affects the mastoid. The ossicles, petrous apex and inner ear are rarely affected.
Central nervous system
The pituitary stalk is the most commonly affected anatomical region. Other affected sites include the infra- and supratentorial parenchyma, venous sinuses, dura mater, and ventricules. Neurodegenerative lesions are distinct from other LCH lesions and have an affinity for the dentate nucleus, cerebellar white matter, brainstem, and basal ganglia.
Lung
The initial lung lesions are nodules that gradually excavate to form thin-walled cysts that fuse and may lead to pneumothorax. Pulmonary fibrosis is a late stage of the disease.
At risk organs
The liver, spleen, bone marrow, and lymph nodes are affected in Letterer-Siwe syndrome, which occurs in infancy. Chronic hepatobiliary LCH is characterized by sclerosing cholangitis that can progress to biliary cirrhosis. Read More

Authors:  Chalard François , O'keane Aurélie , Blondiaux Eleonore , Ducou Le Pointe Hubert

Keywords:  Langerhans Cell Histiocytosis, Imaging, Education

Guleryuz Handan,  Turkan Yilmaz Inci,  Salman Muhammet

Final Pr. ID: Poster #: EDU-037

Pulmonary lesions have been found in fewer than 10% of children with a solitary site of involvement in Langerhans cell histiocytosis(LCH) but in 23%–50% of those with multisystem involvement. The established diagnostic procedures are lung biopsy and bronchoalveolar lavage with a score of more than 5% CD1a-positive cells. Scattered reports of LCH within the thymus exist, typically among children within the setting of multifocal, multisystem disease. Purpose of this presentation is overview of the diverse radiologic manifestations of lung and thymic involvement of Langerhans cell histiocytosis that may be observed with imaging, which allows exact depiction of the extent and severity of disease. Read More

Authors:  Guleryuz Handan , Turkan Yilmaz Inci , Salman Muhammet

Keywords:  langerhans cell histiocytosis