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Isolated gastric Langerhans cell histiocytosis diagnosed by endoscopy and immunohistochemistry in an adult case reportRare Stomach Lesion Identified as Langerhans Cell Histiocytosis

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Key Takeaway
Consider LCH in differential of gastric erosive lesions; confirm with immunohistochemistry.

This publication is a case report combined with a literature review, focusing on isolated gastric Langerhans cell histiocytosis (LCH) in an adult. The report details a single patient whose endoscopic examination revealed an erosive lesion on the greater curvature of the gastric antrum. The diagnosis was confirmed by immunohistochemistry, highlighting the role of histopathology in identifying this rare presentation.

The authors emphasize that isolated gastric LCH is uncommon, especially in adults, and can mimic other gastric lesions. The main finding is the importance of thorough histopathological evaluation to ensure accurate diagnosis and avoid misdiagnosis. The report does not provide data on treatment, follow-up, or outcomes.

Limitations include the small sample size, as this is a single case report. The authors do not report any adverse events or provide information on funding or conflicts of interest. The certainty of the evidence is low, and the findings should be interpreted with caution.

For clinicians, this case serves as a reminder to consider LCH in the differential diagnosis of gastric erosive lesions, particularly when endoscopic appearance is nonspecific. However, given the rarity and the lack of comparative data, the practice relevance is limited to raising awareness rather than guiding specific management decisions.

How this fits prior evidence

This case report extends prior coverage of Langerhans cell histiocytosis by describing an isolated gastric presentation in an adult, whereas prior items focused on pediatric skull involvement and sellar LCH. It contrasts with the pediatric presentation, where skull involvement occurs in 48.8% of cases, by highlighting a gastrointestinal manifestation. The report also complements the radiomics finding (AUC 0.81) by emphasizing histopathologic confirmation, addressing a diagnostic gap for extracranial LCH. However, as a single case, it provides limited generalizable evidence.

Doctors report a rare case of Langerhans cell histiocytosis (LCH) appearing as a stomach lesion in an adult. LCH is a condition where certain immune cells build up in tissues, and it's most often seen in children. This case involved a single adult patient who had an erosive lesion on the greater curvature of the gastric antrum, which is part of the stomach's lower area.

The lesion was found during an endoscopic examination, and the diagnosis was confirmed by immunohistochemistry, a lab test that uses antibodies to identify specific markers on cells. This case is published as a case report and literature review, meaning it describes one patient's experience and also reviews previously reported cases.

Because this is a single case, the findings are limited. It doesn't prove how common this condition is or how it typically behaves in adults. The main takeaway is that doctors should consider LCH when they see unusual stomach lesions, and thorough tissue analysis is important to avoid misdiagnosis.

For patients, this case is a reminder that rare conditions can sometimes explain unusual symptoms or findings. However, it's not a reason to worry, as LCH in the stomach is extremely rare. If you have concerns about a stomach lesion or your health, talk to your doctor.

What this means for you:
A rare stomach lesion was diagnosed as Langerhans cell histiocytosis, highlighting the need for careful tissue analysis.

Common questions

What is Langerhans cell histiocytosis?

Langerhans cell histiocytosis (LCH) is a rare condition where certain immune cells, called Langerhans cells, build up in tissues. It can affect bones, skin, and other organs. It's most common in children, but this case shows it can appear in adults, even in the stomach.

How was the diagnosis made in this case?

The diagnosis was made after an endoscopic examination found an erosive lesion in the stomach. The lesion was then tested with immunohistochemistry, a lab method that uses antibodies to identify specific cell markers, confirming it was Langerhans cell histiocytosis.

Is this finding common?

No, this is a single case report. It describes one adult patient with isolated gastric Langerhans cell histiocytosis. Because it's just one case, it doesn't tell us how common this condition is in the stomach or how it typically behaves in adults.

What should I do if I have a stomach lesion?

If you have a stomach lesion, your doctor will likely recommend tests like an endoscopy and possibly a biopsy. This case highlights the importance of thorough tissue analysis to get an accurate diagnosis. Always follow your doctor's advice for your specific situation.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
Langerhans cell histiocytosis (LCH) is a rare histiocytic disease that predominantly affects young children, with adult cases being exceedingly uncommon. The most frequently affected sites in LCH are bones, lungs, and the pituitary gland, in whom gastrointestinal involvement is scarce. Primary isolated gastric LCH is rarely seen and typically manifests as a polypoid lesion. This article presented a case of LCH in an adult patient, while endoscopic examination revealed an erosive lesion on the greater curvature of the gastric antrum, confirmed by immunohistochemistry. We further discuss the pathogenesis, endoscopic and histopathological characteristics, immunohistochemical findings, relevant differential diagnoses, and current treatment strategies. This report aims to raise clinicians’ awareness of the various endoscopic presentations for LCH and emphasizes the importance of thorough histopathological evaluation to obtain an accurate diagnosis and avoid oversight or misdiagnosis.
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