PMC6974994_01
(a-c) Multiple nodulo-papular, ulcerated lesions in gingiva involving the entire mandibular arch, gingiva of left posterior maxillary arch in relation to the premolars and molars along with similar lesions in the posterosuperior aspect of the left buccal mucosa (yellow arrows)
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F1
Intraoral examination revealed multiple nodulo-papular, ulcerated lesions in gingiva involving entire mandibular arch and left posterior maxillary arch, along with regional teeth mobility (second and third degree) in the same areas [Figure 1a-c]. Few medium-sized, nodulo-papular growths were also observed in the posterosuperior aspect of the left buccal mucosa [Figure 1c].
Orthopantomogram showing severe generalized irregular alveolar bone destruction in the entire mandibular and in the left posterior maxillary alveolar ridge region
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F2
Orthopantomogram revealed severe generalized irregular alveolar bone destruction in the entire mandibular and in the left posterior maxillary alveolar ridge region [Figure 2].
(a) The presence of sheet-like proliferation of Langerhans cells, having coffee bean-shaped appearance, eosinophils, and plasma cells (H and E, x100). (b) Langerhans cells exhibiting positivity for anti-CD1a (x40)
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F3
These cells characteristically resembled Langerhans cells [Figure 3a]. After considering the microscopic features, a diagnosis of "LCH" was made, but to confirm our diagnosis, immunohistochemistry was performed which showed immunopositivity for CD1a antibody [Figure 3b].