Histiocytosis X. Problems in diagnosis

The dentist may play an important role in establishing the diagnosis of histiocytosis X, since the disease often manifests itself initially in the oral cavity. Some of the more important clinical findings that should arouse the clinician's suspicion include (1) marked periodontal disease or cysts of unknown etiology which do not respond to ordinary therapy, (2) delayed healing following extractions, (3) precocious eruption of deciduous teeth, and (4) diabetes insipidus and/or exophthalmos. Two cases of histiocytosis X have been reported. They illustrate not only some of the characteristic findings in this disease but also the importance of grasping the significance of these findings. Since repeated biopsies may be needed before a definitive diagnosis is made, clinical impressions are important.